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DOI: 10.1055/s-0037-1603199
Glioblastoma Multiforme: an Advanced Analysis of 153 Patients and Review of the Literature
Glioblastoma Multiforme: uma análise avançada de 153 pacientes e revisão da literaturaPublikationsverlauf
30. Dezember 2016
16. März 2017
Publikationsdatum:
22. Mai 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00028832/201702/lookinside/thumbnails/10-1055-s-0037-1603199_1600103-1.jpg)
Abstract
Objective Glioblastoma multiforme (GBM) is an aggressive primary tumor with frequent recurrences that leaves patients with a short survival time and a low quality of life. The aim of this study was to review the prognostic factors in patients with glioblastoma multiforme.
Material and Methods The focus of this retrospective study was a group of 153 patients with supratentorial GBM tumors, who were admitted to a tertiary-care referral academic center from 2005 to 2013. The factors associated with survival and local recurrence were assessed using the hazard ratio (HR) function of Cox proportional hazards regression and neural network analysis.
Results Out of the 153 patients, 99 (64.7%) were male. The average age of the patients was 55.69 ± 15.10 years. The median overall survival (OS) and progression-free survival (PFS) rates were 14.0 and 7.10 months respectively. In the multivariate analysis, age (HR = 2.939, p < 0.001), operative method (HR = 7.416, p < 0.001), temozolomide (TMZ, HR = 11.723, p < 0.001), lomustine (CCNU, HR = 8.139, p < 0.001), occipital lobe involvement (HR = 3.088, p < 0.001) and Karnofsky Performance Status (KPS, HR = 4.831, p < 0.001) scores were shown to be significantly associated with a higher OS rate. Furthermore, higher KPS (HR = 7.292, p < 0.001) readings, the operative method (HR = 0.493, p = 0.005), the use of CCNU (HR = 2.047, p = 0.003) and resection versus chemotherapy (HR = 0.171, p < 0.001) were the significant factors associated with the local recurrence of the tumor.
Conclusion Our findings suggest that the use of CCNU and TMZ, the operative method and higher KPS readings are associated with both higher survival and lower local recurrence rates.
Resumo
Objetivo Glioblastoma multiforme (GBM) é um tumor primário agressivo com recorrências frequentes que deixam pacientes com uma curta sobrevida e baixa qualidade de vida. O objetivo deste estudo é rever fatores de prognóstico em pacientes com glioblastoma multiforme.
Material e Métodos O foco deste estudo retrospectivo foi um grupo de 153 pacientes com tumores GBM supratentoriais, os quais deram entrada em um centro acadêmico de atendimento de referência de 2005 a 2013. Fatores associados com a sobrevivência e a recorrência local foram avaliados usando a razão de risco (RR) da regressão de risco proporcional de Cox e análise de redes neurais.
Resultados Dos 153 pacientes, 99 (64,7%) eram homens. A média de idade foi de 55,69 ± 15,10 anos. A sobrevida geral (SG) mediana e a sobrevida de livre progressão (SLP) foram 14,0 e 7,10 meses, respectivamente. Na análise multivariada, idade (RR = 2,939, p < 0,001), método operatório (RR = 7,416, p < 0,001), temozolomida (TMZ, RR = 11,723, p < 0,001), lomustina (CCNU, RR = 8,139, p < 0,001), envolvimento do lobo occipital (RR = 3,088, p < 0,001) e Índice de Desempenho de Karnofsky (IDK, RR = 4,831, p < 0,001) foram identificados como significativamente associados a uma SG maior. Além disso, leituras maiores de IDK (RR = 7,292, p < 0,001), o método operatório (RR = 0,493, p = 0,005), o uso de CCNU (RR = 2,047, p = 0,003) e ressecção versus quimioterapia (RR = 0,171, p < 0,001) foram fatores significativos associados à recorrência local de tumor.
Conclusão Nossos resultados sugerem que o uso de CCNU e TMZ, o método operatório e leituras maiores de IDK estão associados tanto à maior sobrevida quanto à menor recorrência local.
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