Weill-Cornell researchers looking into genetic differences in high-grade gliomas made an unexpected finding: while both boys and girls live longer when their visible tumors are completely removed, the girls lived almost six years longer post-surgery.
Girls with high-grade gliomas sometimes have better odds of survival than do boys, a Weill Cornell Medical College neurosurgeon and colleagues have found.
In a study published in Neurosurgery, Jeffrey P. Greenfield reports on 97 children, median age 11, who were treated for these rare brain tumors. All were patients at Weill Cornell and Memorial Sloan Kettering Caner Center.
Their overall two-year survival rate was 45 percent.
When surgeons were able to completely remove all visible tumor tissue (gross total resection or GTR) children survived a median 3.4 years, compared to 1.6 years for children who had partial or subtotal resection.
Girls who had GTR survived a median 8.1 years, compared to 2.4 years for boys who had GTR.
When surgeons were unable to achieve GTR, both sexes had the same survival rate, a median of 1.4 years.
GTR improved the chances of survival free of recurrent or progressive cancer only in children with one specific subtype of tumor, glioblastoma multiforme.
The finding shows the added importance of getting all the tumor in girls—though surgeons always attempt to achieve GTR.
It also suggests “that there may be differences between the biology of tumors in male and female patients,” Greenfield wrote.
Differences in gender-related gene expression patterns could be a factor in the discrepancy.
The impetus for the study was new research on high-grade gliomas indicating that they have genetically different forms in children compared to ones that occur in adults.
The sex-based survival disparity, “Is one example of an accidental discovery that’s raised some interesting questions and challenged accepted dogma that we’re now exploring,” Greenfield said in an interview with Weill Cornell’s newsroom staff. “Hopefully preliminary data will be available soon that will shed light on this fascinating gender difference.”