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Prognostic factors in patients with glioblastoma multiforme: focus on the pathologic variants

  • Ehsan AlimohammadiEmail author
  • Seyed Reza Bagheri
  • Alireza Sadeghsalehi
  • Parisa Rizevandi
  • Zahra Rezaie
  • Alireza Abdi
Original article

Abstract

The aim of this study was to offer predicting factors for survival in adult patients with glioblastoma multiforme. 153 consecutive patients with high-grade glioma (WHO grade IV) were studied in Imam Reza hospital, Kermanshah University of Medical Science, Kermanshah, Iran, between April 2003 and April 2017. All patients treated with surgical resection and standard postoperative radiotherapy (54 Gy). Using the patients’ charts and electronic medical records system, the following data were obtained: gender, age, Karnofsky performance status (KPS) score on admission, primary vs. secondary type, extent of surgery, tumor location, tumor size, necrosis size, use of Temozolomide (TMZ), pathology subtype, and immunohistochemistry results. Patients were followed from the time of the surgery until the death occurred. Overall survival (OS) and progression-free survival (PFS) were calculated by the Kaplan–Meier method. Survival time curves for various subgroups were compared by the log-rank test. The impact of the suggested prognostic factors on survival was evaluated by univariate and multivariate analyses. Age, gender, KPS, extent of surgery, tumor location, necrosis size, and reoperation in recurrence had not any statistically significant effect on survival. Univariate analysis revealed a significant impact on outcome for pathology subtype (PFS: P < 0.001, OS: P < 0.001), tumor type (primary vs. secondary) (PFS: P = P < 0.001, OS: P < 0.001), tumor size (PFS: P = 0.044, OS: P = 0.04), TMZ therapy (PFS: P < 0.001, OS: P < 0.001), P53 (PFS: P < 0.001, OS: P < 0.001), and Ki67 (PFS: P < 0.001, OS: P < 0.001). In multivariate analysis, independent favorable prognostic factors for survival were pathology subtype (PFS: P < 0.001, OS: P < 0.001), type (PFS: P < 0.001, OS: 0.012), TMZ (PFS: P < 0.001, OS: P < 0.001), P53 (PFS: P < 0.001, OS: P < 0.001), and Ki67 (PFS: P < 0.001, OS: P < 0.001). The results suggest that pathology subtype, primary vs. secondary type, TMZ therapy, P53, and Ki 63 may play an important role in the survival of patients with glioblastoma multiforme. There is no relationship detected between age, gender, KPS, tumor size and location, necrosis size, extent of surgery, reoperation in recurrence, and patient survival.

Keywords

Glioblastoma multiforme Prognostic factors Overall survival Progression-free survival Karnofsky performance status 

Notes

Acknowledgements

We appreciate the clinical Research Development Center of Imam Reza Hospital for their wise advice.

Authors’ contributions

EA and SRB had the idea for this study. EA and PR participated in outlining the concept and design. ZR and ASS did the data acquisition. EA and AA did the statistical analysis and wrote the first draft of the manuscript. EA, SRB, ASS, and AA revised the final manuscript. All authors have read and approved the manuscript.

Funding

There was no external source of funding.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Consent for publication

Not applicable.

Ethics approval and consent to participate

The study received ethics approval by the Kermanshah University of Medical Science Ethics Committee.

Informed consent

All participants provided informed consent prior to their participation.

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Copyright information

© Belgian Neurological Society 2019
corrected publication July 2019

Authors and Affiliations

  1. 1.Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran

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