Scale to predict survival after surgery for recurrent glioblastoma multiforme

  • Park J
  • Hodges T
  • Arko L
 et al. 
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Abstract

PURPOSE: Despite initial treatment with surgical resection, radiotherapy, and chemotherapy, glioblastoma multiforme (GBM) virtually always recurs. Surgery is sometimes recommended to treat recurrence. In this study, we sought to devise a preoperative scale that predicts survival after surgery for recurrent glioblastoma multiforme. PATIENTS AND METHODS: The preoperative clinical and radiographic data of 34 patients who underwent re-operation of recurrent GBM tumors were analyzed using Kaplan-Meier survival analysis and Cox proportional hazards regression modeling. The factors associated with decreased postoperative survival (P < .05) were used to devise a prognostic scale which was validated with a separate cohort of 109 patients. RESULTS: The factors associated with poor postoperative survival were: tumor involvement of prespecified eloquent/critical brain regions (P = .021), Karnofsky performance status (KPS) < or = 80 (P = .030), and tumor volume > or = 50 cm(3) (P = .048). An additive scale (range, 0 to 3 points) comprised of these three variables distinguishes patients with good (0 points), intermediate (1 to 2 points), and poor (3 points) postoperative survival (median survival, 10.8, 4.5, and 1.0 months, respectively; P < .001). The scale identified three statistically distinct groups within the validation cohort as well (median survival, 9.2, 6.3, and 1.9 months, respectively; P < .001). CONCLUSION: We devised and validated a preoperative scale that identifies patients likely to have poor, intermediate, and good relative outcomes after surgical resection of a recurrent GBM tumor. Application of this simple scale may be useful in counseling patients regarding their treatment options and in designing clinical trials

Author-supplied keywords

  • Adult
  • Aged
  • Arthritis
  • BRAIN
  • CANCER
  • CHEMOTHERAPY
  • CLINICAL TRIAL
  • CLINICAL TRIALS
  • Female
  • Humans
  • Kaplan-Meiers Estimate
  • Karnofsky Performance Status
  • MORTALITY
  • Male
  • Methods
  • Middle Aged
  • Molecular
  • NEUROLOGICAL DISORDERS
  • NEUROONCOLOGY
  • Neoplasm Staging
  • Neurological
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Questionnaires
  • RADIOTHERAPY
  • RECURRENCE
  • REOPERATION
  • RESECTION
  • Risk Assessment
  • Risk Factors
  • SURGERY
  • Support
  • Survival
  • Survival Analysis
  • TUMOR
  • Treatment Outcome
  • Tumor Burden
  • analysis
  • disorders
  • glioblastoma
  • pathology
  • treatment

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  • PMID: 20644085

Authors

  • J K Park

  • T Hodges

  • L Arko

  • M Shen

  • Iacono D Dello

  • A McNabb

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