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A
multivariate analysis of 416 patients with glioblastoma multiforme: prognosis,
extent of resection, and survival
Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, Lang FF,
McCutcheon IE, Hassenbusch SJ, Holland E, Hess K, Michael C, Miller D, Sawaya R
Department of Neurosurgery, The University of Texas M. D.
Anderson Cancer Center, Houston 77030, USA
Object.The extent of tumor resection that should be undertaken in
patients with glioblastoma multiforme (GBM) remains controversial.
The purpose of this study was to identify significant independent predictors of
survival in these patients and to determine whether the extent of resection was
associated with increased survival time.
Methods. The authors retrospectively analyzed 416 consecutive
patients with histologically proven GBM who underwent tumor resection at the
authors' institution between June 1993 and June 1999.
Volumetric data and other tumor characteristics identified on magnetic resonance
(MR) imaging were collected prospectively.
Conclusions. Five independent predictors of survival were
identified: age, Karnofsky Performance Scale (KPS) score, extent of resection,
and the degree of necrosis and enhancement on preoperative MR imaging
studies.
A significant survival advantage was associated with resection of 98% or more of
the tumor volume (median survival 13 months, 95% confidence interval [CI]
11.4-14.6 months), compared with 8.8 months (95% CI 7.4-10.2 months; p <
0.0001) for resections of less than 98%.
Using an outcome scale ranging from 0 to 5 based on age, KPS score, and tumor
necrosis on MR imaging, we observed significantly longer survival in patients
with lower scores (1-3) who underwent aggressive resections, and a trend toward
slightly longer survival was found in patients with higher scores (4-5).
Gross-total tumor resection is associated with longer survival in patients with
GBM, especially when other predictive variables are favorable.
PMID: 11780887 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11780887&dopt=Abstract
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