The level of manganese superoxide dismutase content is an independent prognostic factor for glioblastoma. Biological mechanisms and clinical implications

We address the issue of the role of manganese superoxide dismutase in tumor igenesis by studying a relatively homogeneous group of tumours for the corr elation between amount of this anti-oxidant enzyme and prognosis. The clini cal outcome of 30 patients affected by glioblastomas whose manganese supero xide dismutase content had been established at the time of first diagnosis is compared. When the survival of patients is stratified according to manga nese superoxide dismutase level in the tumour, a link of these levels and p rognosis can be observed. Patients with high levels of manganese superoxide dismutase show a median survival time of 6.11 months, while patients whose tumours display a low amount of MnSOD have a median survival time of 12.17 months. To assess the upstream mechanisms that sustain the increase in man ganese superoxide dismutase content in brain neuroepithelial tumours, we al so studied the expression of p53 in a series of 17 astrocytomas of various grading. In all tested astrocytomas, high manganese superoxide dismutase co ntent is associated with cytoplasmic accumulation of p53. Thus glioblastoma s can be divided into two distinct groups on the basis of their content of manganese superoxide dismutase, having 'better' or 'worse' prognosis, respe ctively. The use of this protein as a marker may help to define therapeutic strategies in the clinical management of glioblastoma. (C) 2001 Cancer Res earch Campaign.