Retrospective and Randomized Analysis of Influence and Correlation of Clinical and Molecular Prognostic Factors in a Mono-Operative Series of 122 Patients with Glioblastoma Treated with STR or GTR

Abstract

Glioblastoma is a solid, infiltrating, and the most frequent highly malignant primary brain tumor. Our aim was to find the correlation between sex, age, preoperative Karnofsky performance status (KPS), presenting with seizures, and extent of resection (EOR) with overall survival (OS), progression-free survival (PFS), and postoperative KPS, along with the prognostic value of IDH1, MGMT, ATRX, EGFR, and TP53 genes mutations and of Ki67 through the analysis of a single-operator series in order to avoid the biases of a multi-operator series, such as the lack of homogeneity in surgical and adjuvant nonsurgical treatments. A randomized retrospective analysis of 122 patients treated by a single first operator at Sapienza University of Rome was carried out. After surgery, patients followed standard Stupp protocol treatment. Exclusion criteria were: (1) patients with primary brainstem and spinal cord gliomas and (2) patients who underwent partial resections (resection < 90%) or a biopsy exclusively for diagnostic purposes. Statistical analysis with a simultaneous regression model was carried out through the use of SPSS 25® (IBM). Results showed statistically significant survival increase in four groups: (1) patients treated with gross total resection (GTR) (p < 0.030); (2) patients with mutation of IDH1 (p < 0.0161); (3) patients with methylated MGMT promoter (p < 0.005); (4) patients without EGFR amplification or EGFRvIII mutation (p < 0.035). Higher but not statistically significant survival rates were also observed in: patients <75 years, patients presenting with seizures at diagnosis, patients affected by lesions in noneloquent areas, as well as in patients with ATRX gene mutation and Ki-67 < 10%.

Prognostic Value of ATRX and p53 Status in High-Grade Glioma Patients in Morocco

“…The IDH1R132H mutation has been detected in 13.5% of cases, particularly in young patients, compared to 10% and 12.9% in previous studies [19][20][21]. In line with several studies, this mutation was associated with a significant increase in OS for patients [17,22,23].…”

Impact of 1p/19q Codeletion Status in The Outcome of Patients Affected By Oligodendroglioma and Diffuse Astrocytoma: A Retrospective Single Surgeon Series With 1.5 Io-MRI Guided Surgery

“…In total, 6.38% of the patients belonging to the Diffuse Astrocytoma subgroup presented TP53 mutation, which disclosed a statistically signi cant negative association with OS (r=-.513; p=.018; Standard Error .159) and with PFS (r=-.519; p=.016; Standard Error .161) and 9.18% of these patients presented also a EGFR ampli cation/EGFRvIII mutation, negatively correlated with OS (r=-.544; p=.011; Standard Error .162) e PFS either (r=-.561; p=.008; Standard Error .162 - Table 2). The EGFR ampli cation/EGFRvIII mutation is already reported to be a negative prognostic factor for both OS and PFS in glioma after malignant transformation [7]. 3 .We found a statistically signi cant difference between these subgroups for the following dependent variables: OS (p=.0001), PFS (p=.001) and Malignant Trasformation (p=.001).…”

Role of 1p/19q Codeletion in Diffuse Low-grade Glioma Tumour Prognosis

“…TP53 mutation and Epidermal growth factor receptor (EGFR) amplification/EGFR variant III mutation and their predictive value was investigated in both groups. The data analysis methodology is consistent with the one used by Salvati et al (11).…”