Sex-specific impact of patterns of imageable tumor growth on survival of primary glioblastoma patients

Paula Whitmire, Cassandra R. Rickertsen, Andrea Hawkins-Daarud, Eduardo Carrasco, Julia Lorence, Gustavo De Leon, Lee Curtin, Spencer Bayless, Kamala Clark-Swanson, Noah C. Peeri, Christina Corpuz, Christine Paula Lewis-De Los Angeles, Bernard R. Bendok, Luis Gonzalez-Cuyar, Sujay Vora, Maciej M. Mrugala, Leland S. Hu, Lei Wang, Alyx Porter, Priya KumthekarSandra K. Johnston, Kathleen M. Egan, Robert Gatenby, Peter Canoll, Joshua B. Rubin, Kristin R. Swanson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences. Methods: Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females). Results: Among males, tumor (T1Gd) radius was a predictor of overall survival (HR = 1.027, p = 0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR = 1.011, p < 0.001). Female extreme survivors had significantly smaller tumors (T1Gd) (p = 0.010 t-test), but tumor size was not correlated with female overall survival (p = 0.955 CPH). Both male and female extreme survivors had significantly lower tumor cell net proliferation rates than other patients (M p = 0.004, F p = 0.001, t-test). Conclusion: Despite similar distributions of the MR imaging parameters between males and females, there was a sex-specific difference in how these parameters related to outcomes.

Original languageEnglish (US)
Article number447
JournalBMC cancer
Issue number1
StatePublished - May 19 2020


  • Biomathematical models
  • Glioblastoma
  • Neuroimaging
  • Sex differences

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research


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