BACKGROUND: Glioblastoma carries a poor prognosis primarily because of its high rate of recurrence. Similarly, anaplastic gliomas without IDH mutation present poor prognosis similar to glioblastoma. The ability to predict the recurrence pattern and timing would be highly useful for determining effective treatment strategies. We here examined high grade glioma to determine their recurrence pattern and the expression of CD133, a cell surface marker of glioma stem cells. METHODS: We retrospectively analyzed 198 patients with high grade gliomas (glioblastoma 112 cases, anaplastic glioma 86 patients,). Patients' characteristics, recurrence pattern, and prognosis were obtained from medical records. CD133 expression was examined by western blotting and immunohistochemistry, and IDH mutation was examined by direct sequencing. RESULTS: Of the 112 glioblastoma patients, 99 suffered recurrence. The first recurrence was local in 77 patients and distant in 22 patients. Among the factors to predict the pattern of recurrence, CD133 expression was significantly higher in distant than in local recurrence. As for anaplastic gliomas, of the 86 patients, 58 carried IDH mutation and 39 patients experienced recurrence. The first recurrence was local and distant in 26 and 13 patients, respectively. Patients without IDH mutation exhibited significantly higher CD133 expression and more frequent distant recurrence than those with IDH mutation. Patients with high CD133 expression showed shorter overall survival. CONCLUSIONS: The expression of CD133 may be a predictor of the pattern and timing of recurrence of primary glioblastoma. Patients with anaplastic gliomas without IDH mutation experience distant recurrence and exhibit high CD133 expression, indicating that this subset may share some malignant characteristics with glioblastoma. SECONDARY CATEGORY: Clinical Neuro-Oncology.