Multi-center study finds postoperative residual non-enhancing component of glioblastoma as a new determinant of patient outcome
The aim of the present study is to assess whether postoperative residual non-enhancing volume (PRNV) is correlated and predictive of overall survival (OS) in glioblastoma (GBM) patients.
We retrospectively analyzed a total 134 GBM patients obtained from The University of Texas MD Anderson Cancer Center (training cohort, n = 97) and The Cancer Genome Atlas (validation cohort, n = 37). All patients had undergone postoperative magnetic resonance imaging immediately after surgery. We evaluated the survival outcomes with regard to PRNV. The role of possible prognostic factors that may affect survival after resection, including age, sex, preoperative Karnofsky performance status, postoperative nodular enhancement, surgically induced enhancement, and postoperative necrosis, was investigated using univariate and multivariate Cox proportional hazards regression analyses. Additionally, a recursive partitioning analysis (RPA) was used to identify prognostic groups.
Our analyses revealed that a high PRNV (HR 1.051; p-corrected = 0.046) and old age (HR 1.031; p-corrected = 0.006) were independent predictors of overall survival. This trend was also observed in the validation cohort (higher PRNV: HR 1.127, p-corrected = 0.002; older age: HR 1.034, p-corrected = 0.022). RPA analysis identified two prognostic risk groups: low-risk group (PRNV < 70.2 cm3; n = 55) and high-risk group (PRNV ≥ 70.2 cm3; n = 42). GBM patients with low PRNV had a significant survival benefit (5.6 months; p = 0.0037).
Our results demonstrate that high PRNV is associated with poor OS. Such results could be of great importance in a clinical setting, particularly in the postoperative management and monitoring of therapy.
KeywordsGlioblastoma Survival Postoperative Invasion
We thank The Cancer Genome Atlas and The Cancer Imaging Archive initiatives for making the clinical and imaging data publicly available. This research was partially funded by the John S. Dunn Sr. Distinguished Chair in Diagnostic Imaging Fund, MD Anderson Brain Tumor Center Program, MD Anderson Cancer Center startup funding, and the Cancer Prevention and Research Institute of Texas Individual Investigator Research Award (RP160150).
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
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