Relevant changes of the molecular profile in the recurrence of glioblastomas with respect to the correspondent primary tumors M. Idoate * , J. Echeveste, R. Diez Valle, M. Montanana, J. Sola, T. Labiano * University of Navarra, Dept. of Pathology, Pamplona, Spain Objective: In the literature, there is not enough information about changes of relevant molecular parameters in the recurrent glioblastoma. Method: The study included a total of 11 grade IV astrocytomas (OMS) and their correspondent recurrences in a series of patients treated by 5-ALA guided surgery. All patients received similar treatment. A comparative histologic and molecular study which included LOH of PTEN region, EGFR amplification SISH, methylation of MGMT by MSP-PCR and sequencing of EGFR variant III mutation on representative tumor samples was obtained. Results: The recurrences appeared adjacent to surgical cavity in seven cases. The mean time between the diagnosis of primary and the recurrence was 500 days (215-1670). The primary glioblastomas showed LOH10q23 in 82 % of cases, hypermethylation of MGMT in 50 %, EGFR amplification in 45 % and EGFRvIII in 37 %. In five cases (45 %) the molecular profile of the recurrences was different to the primaries and most of them (80 %) in the group of vaccines treated glioblastomas. The molecular profile change included one to several of the studied parameters. In one case all of the molecular parameters had changed. Conclusion: The molecular profile change of the recurrences of glioblastomas in respect to the primaries is a frequent event that could be due to the selection of tumor cells due to both heterogeneity and treatment effect. Objective: There is not literature reference on the prognostic significance of the proliferative activity in the border of tumor. A large series of patients with glioblastomas operated by fluorescence guided surgery with uniform treatment and enough follow-up have been studied. Method: A total of 207 samples of different fluorescence quality from 67 glioblastomas, 44 primaries and 23 recurrences, were studied. For each tumor, the maximum value of Ki-67 was determined by a semiquantitative counting by two observers and by an autoanalyzer. These values were compared with relevant oncologic parameters. Results: The results of Ki67 according both counting methods were concordant. The Ki67max values of red (center), pink (intermediate) and blue (border) fluorescence samples obtained by quantitative analysis were 28 % 11 % and 6 %. In the Cox regression analysis for overall survival, the Ki67 value was an independent prognostic factor, stronger than other relevant clinical parameters studied (p=0.002). In the Kaplan-Meier for a Ki67 cut-off of 5 %, the median overall survival was 25.1 months against 13.0 months (p=0.023). For the patients with recurrent glioblastomas the overall survival according to Ki67 values was also significant (p=0.017). Conclusion: The evaluation of the proliferative activity by Ki-67 in the border of tumor defined by 5-ala fluorescence is a relevant independent prognostic marker of primary and recurrent glioblastomas. Objective: According to the levels of estrogen receptor (ER) expression, primary breast carcinoma (BC) cases are divided into two groups: ER-positive and ER-negative (Godhirsch et al. 2011) . In metastatic BC, and especially in brain metastases (BM) of BC, the role of ER expression is not clearly defined. Aim: Investigate ER expression levels in brain metastases of BC and evaluate its prognostic significance. Method: Surgically obtained tumor specimens from sixty BC female patients (median age 52, ranges 29-73) with BM BC were stained with antibodies to ER (DAKO). IHC expression was evaluated according to the semi-quantitative method. Survival was estimated by means of Kaplan-Meyer curves. Statistical analysis was performed using STAITIS-TICA 8.0 software. Results: ER expression was detected in 52 % of patients (31/60), and 48 % (29/60) were ER-negative. Median time period between primary diagnosis and BM development was significantly (p<0.05) longer in ER-positive group compared to ER-negative group (48 and 23 months, respectively). Recurrent BM developed in both groups with a similar frequency (32 % and 34 %, respectively). General survival was significantly (p=0,026) higher in ER-positive patients compared to that of ER-negative group. Conclusion: ER expression is considered to be an important prognostic factor for development of BMBC. Nevertheless, further studies involving more patients with BMBC are required.