The study investigated how the overall survival (OS) of patients with glioblastoma (GBM) may depend on the brain’s structural connectivity, introducing a new index called the tract density index (TDI).
Two groups of surgically treated patients were examined: one cohort in Italy (99 valid patients) and one in Germany (58 valid patients). The analysis showed that TDI is significantly associated with survival, displaying greater stability compared to other classic prognostic factors such as age, functional status, MGMT methylation, and extent of resection.
The results confirmed that GBMs located in regions with lower white matter tract density are associated with longer survival. TDI proved to be a reliable pre-surgical predictor, valuable both in clinical practice and in clinical trials, suggesting that the outcome of GBM depends, at least in part, on the structural organization of the patient’s brain.
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