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Scale to predict survival after surgery for recurrent glioblastoma multiforme.


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.

SUBMITTER: Park JK 

PROVIDER: S-EPMC2940401 | biostudies-literature | 2010 Aug

REPOSITORIES: biostudies-literature

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Publications

Scale to predict survival after surgery for recurrent glioblastoma multiforme.

Park John K JK   Hodges Tiffany T   Arko Leopold L   Shen Michael M   Dello Iacono Donna D   McNabb Adrian A   Olsen Bailey Nancy N   Kreisl Teri Nguyen TN   Iwamoto Fabio M FM   Sul Joohee J   Auh Sungyoung S   Park Grace E GE   Fine Howard A HA   Black Peter McL PM  

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20100719 24


<h4>Purpose</h4>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.<h4>Patients and methods</h4>The preoperative clinical and radiographic data of 34 patients who underwent re-operation of recurrent GBM tumors were analyzed usin  ...[more]

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