Clinical factors influencing survival prognosis in patients with malignant glioma

Abstract

Objective To investigate the clinical factors influencing survival prognosis in patients with supratentorial malignant glioma (MG). Methods A total of 194 patients with MG,admitted to our hospital from January 2004 to December 2009, were chosen in our study; anaplastic astrocytoma (AA) was noted in 120 patients and glioblastoma multiforme (GB) was noted in 74 patients.Their survival status was followed-up.Survival related statistics were calculated using the Kaplan-Meier method,and differences between survival curves were analyzed by the log-rank test.The interaction of each prognostic factor and their effect on overall survival (OS) and progression-free survival (PFS) were analyzed with the Cox proportional hazards model. Results The median PFS and OS in AA patients were 18 and 21 months,and those in GB patients were 10 and 12 months.When PFS and OS were used as endpoints,AA patients lived longer than GB ones, while patients ≤ 40 years old lived longer than those ＞40 years old; patients with Karnofsky performance status (KPS) scored 80-100 had longer survival than those with KPS scored 60-70; patients with preoperative seizure enjoyed the same situation as compared with those without preoperative seizure. Both univariate and multivariate Cox analyses confirmed that independent influencing factors were age,KPS scores,grade of pathology and appearance of preoperative seizure; patients with young age, high KPS scores, low grade of pathology and preoperative seizure had longer PFS and OS than those without. Conclusion Young age,high KPS scores,low grade of pathology and preoperative seizure are protective prognostic factors in patients with MG,while gender,tumor size,tumor location,and extent of resection have no prognostic significance; the prognostic significance of contrast - enhancing is uncertain. Key words: Glioma; Glioblastoma; Anaplastic astrocytoma; Prognosis