NIMG-84. TUMOR LOCATION IS PROGNOSTIC FOR OVERALL SURVIVAL IN NEWLY DIAGNOSED GLIOBLASTOMA: EVIDENCE FROM 1,458 PATIENTS POOLED FROM INTERNATIONAL TRIALS, SINGLE INSTITUTION DATABASES, AND MULTICENTER CONSORTIUMS
Bibliographic record
Abstract
The prognostic significance of tumor location in newly diagnosed GBM (NDGBM) remains provocative and poorly understood. In this study we pooled imaging data in >1,400 NDGBM patients from international multicenter clinical trials, single institution databases, and multicenter clinical trial consortiums to identify relationships between tumor location on OS, independent of clinical and genetic or molecular characteristics. Data from 1,458 newly diagnosed GBM patients from the following sources were included in our imaging database: 1) a single institution database from UCLA (N=398; Training Set 1); 2) patients treated within the Ben and Cathy Ivy Foundation for Early Phase Clinical Trials Consortium (N=262; Training Set 2); and 3) AVAglio – an international phase III trial comparing chemoradiation plus bevacizumab (N=404) vs. placebo (N=394) used as a validation set. Voxel-wise statistical parameter mapping (SPM) using multivariate Cox regression was performed to determine the influence of tumor location on OS. Covariates included in the SPM model consisted of clinical variables (age, gender, etc.), MGMT status, molecular phenotype (when available), initial treatment including extent of resection, and RPA class. Separate maps were created for all three datasets independently (UCLA, Ivy, and AVAglio) to validate the reproducibility of the SPMs. Data suggest tumors localized to the left or right parietal lobe, left insula, left or right thalamus, and left frontal lobe have an elevated hazard ratio (HR>1.5, P<0.05), whereas tumors localized to the right frontal lobe or left or right anterior cingulate had a significantly lower risk of death (HR<0.8, P<0.05), independent of other covariates. Frontal lobe and anterior cingulate regions were associated with the proneural molecular subtype and younger patients, and mesenchymal tumors and tumors in older patients were localized more posterior. Results from the current study further support the hypotheses that tumor location significantly influences survival in patients with NDGBM.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".