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Tytuł:
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Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale - a bicentric retrospective study.
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Autorzy:
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Barz M; Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany. .
Gerhardt J; Department of Neurosurgery, Helios Klinikum Berlin Buch, Berlin, Germany.
Bette S; Department of Diagnostic and Interventional Radiology, Universitätsklinikum Augsburg, Augsburg, Germany.; Department of Neuroradiology, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.
Aftahy AK; Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany.
Huber T; Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Combs SE; Helmholtz Zentrum Munich (HMGU), Department of Radiation Sciences (DRS), Institute of Innovative Radiotherapy (iRT), Munich, Germany.; Deutsches Konsortium für Translationale Krebsforschung (DKTK) (German Cancer Consortium), Partner Site Munich, Munich, Germany.
Ryang YM; Department of Neurosurgery, Helios Klinikum Berlin Buch, Berlin, Germany.
Wiestler B; Department of Neuroradiology, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.
Skardelly M; Department of Neurosurgery, University of Tübingen, Tübingen, Germany.
Gepfner-Tuma I; Department of Neurosurgery, University of Tübingen, Tübingen, Germany.
Behling F; Department of Neurosurgery, University of Tübingen, Tübingen, Germany.
Schmidt-Graf F; Department of Neurology, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.
Meyer B; Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany.
Gempt J; Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany.
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Źródło:
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BMC neurology [BMC Neurol] 2021 Nov 15; Vol. 21 (1), pp. 446. Date of Electronic Publication: 2021 Nov 15.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BioMed Central, [2001-
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MeSH Terms:
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Brain Neoplasms*/surgery
Glioblastoma*/surgery
Aged ; Aged, 80 and over ; Female ; Humans ; Karnofsky Performance Status ; Male ; Middle Aged ; Neurosurgical Procedures ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Tumor Burden
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References:
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Contributed Indexing:
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Keywords: EOR; Glioblastoma; Karnofsky performance status scale; Surgery
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Entry Date(s):
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Date Created: 20211116 Date Completed: 20211117 Latest Revision: 20220428
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Update Code:
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20240105
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PubMed Central ID:
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PMC8591917
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DOI:
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10.1186/s12883-021-02424-0
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PMID:
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34781889
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Backround: Median overall survival (OS) after diagnosis of glioblastoma (GBM) remains 15 months amongst patients receiving aggressive surgical resection, chemotherapy and irradiation. Treatment of patients with a poor preoperative Karnofsky Performance Status Scale (KPSS) is still controversial. Therefore, we retrospectively assessed the outcome after surgical treatment in patients with a KPSS of ≤60%.
Methods: We retrospectively included patients with a de-novo glioblastoma WHO °IV and preoperative KPSS ≤60%, who underwent surgery at two neurosurgical centres between September 2006 and March 2016. We recorded pre- and postoperative tumour volume, pre- and postoperative KPSS, OS, age and MGMT promoter status.
Results: One hundred twenty-three patients (58 females/65 males, mean age 67.4 ± 13.4 years) met the inclusion criteria. Seventy-five of the 123 patients (61%) underwent surgical resection. 48/123 patients (39%) received a biopsy. The median preoperative and postoperative tumour volume of all patients was 33.0 ± 31.3 cm 3 (IR 15.0-56.5cm 3 ) and 3.1 ± 23.8 cm 3 (IR 0.2-15.0 cm 3 ), respectively. The median KPSS was 60% (range 20-60%) preoperatively and 50% (range 0-80%) postoperatively. Patients who received a biopsy showed a median OS for patients who received a biopsy only was 3.0 months (95% CI 2.0-4.0 months), compared to patients who had a resection and had a median OS of 8 months (95% CI 3.1-12.9 months). Age (p < 0.001, HR: 1.045 [95% CI 1.022-1.068]), postoperative tumour volume (p = 0.02, HR: 1.016 [95% CI 1.002-1.029]) and MGMT promotor status (p = 0.016, HR: 0.473 [95% CI 0.257-0.871]) were statistically significant in multivariate analysis. In subgroup analyses only age was shown as a significant prognostic factor in multivariate analyses for patients receiving surgery (p < 0.001, HR: 1.046 [95% CI 1.022-1.072]). In the biopsy group no significant prognostic factors were shown in multivariate analysis.
Conclusion: GBM patients with a preoperative KPSS of ≤60% might profit from surgical reduction of tumour burden.
(© 2021. The Author(s).)
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