Analysis of prognostic influencing factors of glioblastoma multiforme

Abstract

Objective To investigate the prognostic influencing factors in patients with glioblastoma multiforme (GBM) after surgery and adjuvant radiochemotherapy. Methods From December 2004 to December 2014, the clinical data of 61 patients with GBM operated and treated with postoperative adjuvant radiochemotherapy at the Department of Neurosurgery, Guangzhou General Hospital of Guangzhou Military Command were analyzed retrospectively. The influence of 16 factors on the survival time of the patients were evaluated, including gender, age, lesion site, number of lesions, tumor volume, disease duration, preoperative Karnofsky Performance Scale (KPS) score, operation duration, operative bleeding volume, tumor residual volume, extent of resection, postoperative complications, secondary tumor resection, radiotherapy, chemotherapy, and concurrent radiochemotherapy. Multivariate Cox regression analysis was conducted for the indices of the differences with statistical significance of Kaplan-Meier single factor analysis. Results The survival time of 61 patients was 1 to 63 months, and the median survival time was 14.0 months, 1-year, 2-year, and 5-year survival rates were 75.4%, 34.4% and 1.6%, respectively. The univariate analysis of Kaplan-Meier method showed that preoperative KPS score, operation time, residual tumor, total resection, radiotherapy, chemotherapy and concurrent radiochemotherapy were the factors of impacting on the survival time of patients. Multivariate Cox regression analysis showed that preoperative KPS score (OR, 0.302, 95% CI 0.153-0.597, P=0.001), residual tumor volume (OR, 0.225, 95% CI 0.114~0.441, P=0.000) and concurrent radiochemotherapy (OR, 0.275, 95% CI 0.128-0.591, P=0.001) were the independent factors for impacting the prognosis of patients with GBM. Conclusions Surgery is still the most important means for the treatment of GBM. The preoperative KPS score is ≥70, the postoperative residual tumor volume is ≤3 cm3, and postoperative concurrent radiochemotherapy may prolong the survival time of patients. Key words: Glioblastoma, multiforme; Risk factors; Prognosis