Angiogenesis predicts survival in pediatric glioblastoma multiforme

The growth of neoplastic tissue depends on the ability of cells to stimulate the host vasculature, leading to new vessel development. This process has been assessed in adult glioblastoma multiforme (GBM), and related with prognosis. No studies have focused this tissue in pediatric GEM. Angiogenesis was evaluated in 6 pediatric supratentorial GEM using multiple criteria, including immunoistochemical TN-C expression, contrast enhancement on preoperative CT scan, vascular hyperplasia (VH) and endothelial proliferation (EP) on histological sections. We quantified the influence of angiogenesis on prognosis, assessing postoperative outcomes and survival length. Cases with low TN-C expression, minimal/moderate contrast enhancement, minimal/ moderate VH and EP had best outcomes and survivals. The case with marked TN-C expression, preoperative CT contrast enhancement, VH and EP had poorest outcome and shortest survival. High angiogenesis was associated with a poor prognosis, while was not correlated with preoperative clinical history, neurological findings, or tumour site. Although based on a limited number of patients, this study demonstrated that angiogenesis is related with pediatric GBM prognosis.