Influence of extent of surgical resection on factors for predicting the prognosis of glioblastomas

Wang Yongzhi; Yang Fan; Ji Yuchen; Li Yanwei; You Gan; Zhang Wei; Jiang Tao

doi:10.11850/j.issn.1009-122X.2015.07.001

Abstract：Objective To investigate the influence of extent of surgical resection on the factors predicting prognosis in patients with glioblastoma. Methods Clinical data of 135 patients who received maximal extent of tumor resection and adjuvant chemoradiotherapy were analyzed retrospectively. The influences of surgical extent on clinical prognostic value of classical prognostic factors were analyzed. Results Based on the imaging evaluation after surgery, total tumor resection was achieved in 57 patients and subtotal resection in 78. The survival time was 20.8 and 13.8 months in total tumor resection and subtotal resection groups respectively and there was a significant difference between the two groups (P=0.003). Besides, a univariate analysis revealed that age (P=0.001), preoperative KPS score (P=0.001), isocitrate dehydrogenase 1 (IDH1) status (P=0.005) and MGMT promoter status (P=0.017) were correlated with the prognosis. However, further subgroup analysis found the prognostic relevance of MGMT did not showed statistical significance (P=0.464) and the prognostic value of age was also weakened (P=0.046) under total tumor resection. The COX analysis identified the only independent prognostic factors for overall survival time were KPS score (relative risk 0.365, P=0.011) and IDH1 status (relative risk 0.436, P = 0.044). Conclusion The extent of tumor resection influences the prognostic values of the predictors for prognosis in glioblastoma, which should be taken into full account when assessing the factors associated with prognosis.