Scale to predict survival after surgery for recurrent glioblastoma multiforme. Academic Article uri icon

Overview

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.

authors

  • Park, John
  • Hodges, Tiffany
  • Arko, Leopold
  • Shen, Michael
  • Dello Iacono, Donna
  • McNabb, Adrian
  • Olsen Bailey, Nancy
  • Kreisl, Teri Nguyen
  • Iwamoto, Fabio M
  • Sul, Joohee
  • Auh, Sungyoung
  • Park, Grace E
  • Fine, Howard Alan
  • Black, Peter McL

publication date

  • July 19, 2010

Research

keywords

  • Glioblastoma
  • Surveys and Questionnaires

Identity

PubMed Central ID

  • PMC2940401

Scopus Document Identifier

  • 77956244685

Digital Object Identifier (DOI)

  • 10.1016/j.pharmthera.2010.04.015

PubMed ID

  • 20644085

Additional Document Info

volume

  • 28

issue

  • 24