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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 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

  • Genetics
  • Oncology
  • Cancer Research


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