The prognostic value of peri-operative neurological performance in glioblastoma patients

Dietterle, Johannes; Wende, Tim; Wilhelmy, Florian; Eisenlöffel, Christian; Jähne, Katja; Taubenheim, Sabine; Arlt, Felix; Meixensberger, Jürgen

doi:10.1007/s00701-019-04136-4

Cited by 20 publications

(20 citation statements)

References 30 publications

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“…34 A recent publication by Dietterle et al revealed that the hazard ratio of unilobar tumors is twice that of multilobar tumors. 35 Tumors located in mixed areas are adjacent to many critical arteriovenous structures and functional areas. Therefore, tumors located in these regions may increase the difficulty of operative and incidence of complications, which could result in early mortality and unfavorable long-term clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Predictors of Early Mortality Risk in Isocitrate Dehydrogenase-Wild-Type Glioblastoma Patients Treated with Standard Therapy

Zhao¹,

Li²,

Guo³

et al. 2021

CMAR

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Early identification of early mortality for glioblastoma (GBM) patients based on laboratory findings at the time of diagnosis could improve the overall survival. The study aimed to explore preoperative factors associated with higher risk of early death (within 1 year after surgery) for isocitrate dehydrogenase (IDH)-wild-type (wt) GBM patients. Patients and Methods: We conducted a retrospective analysis of 194 IDH-wt GBM patients who underwent standard treatment. The probability of dying within 1 year after gross total resection (GTR) was defined as the end point "early mortality". Retrospective collection of predictive factors including clinical characteristics and laboratory data at diagnosis. Results: Median follow-up time after GTR was 16 months (3-41 months). Forty-two patients died within 1 year after surgery (1-year mortality rate: 21.6%). All potential predictive factors were assessed on univariate analyses, which revealed the following factors as associated with higher risk of early death: older age (P = 0.013), occurrence of nonseizures symptoms (P = 0.042), special tumor positions (P = 0.046), higher neutrophil-tolymphocyte ratio (NLR) (P = 0.015), higher red blood cell distribution width (RDW) (P = 0.019), higher lactate dehydrogenase (LDH) (P = 0.005), and higher fibrinogen (FIB) (P = 0.044). In a multivariate analysis, tumor location (P = 0.012), NLR (P = 0.032) and LDH (P = 0.002) were independent predictors of early mortality. The C-index of the nomogram was 0.795. The calibration curve showed good agreement between prediction by nomogram and actual observation. Conclusion: Tumor location, preoperative elevated NLR and serum LDH level were independent predictors for 1-year mortality after GTR. We indicate that increased preoperative NLR or LDH may guide patients to review head magnetic resonance imaging (MRI) more frequently and regularly to monitor tumor progression.

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Section: Discussionmentioning

confidence: 99%

Preoperative Predictors of Early Mortality Risk in Isocitrate Dehydrogenase-Wild-Type Glioblastoma Patients Treated with Standard Therapy

Zhao¹,

Li²,

Guo³

et al. 2021

CMAR

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“…A good PS is crucial for tolerance, ability to complete, and thus maximal benefit from adjuvant treatment. 47–49 5-ALA-GS was associated with a better PS at 6 months after surgery in both unadjusted and adjusted analysis and a higher probability of patients completing their adjuvant treatment. This further supports the use of this adjunct in GBM surgery, not only for its direct effect on EoR and survival but also for its impact on PS and facilitating adjuvant therapies.…”

Section: Discussionmentioning

confidence: 88%

5-Aminolevulinic acid-guided resection improves the overall survival of patients with glioblastoma—a comparative cohort study of 343 patients

Mirza

Christodoulides

Lavrador

et al. 2021

Neuro-Oncology Advances

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Background 5-Aminolevulic Acid guided surgery (5-ALA-GS) improves the extent of resection and progression free survival in patients with glioblastoma multiforme (GBM). Methods Single-center retrospective cohort study of adult patients with GBM who had surgical resection between 2013 and 2019, 5-ALA guided versus a non 5-ALA cohort. Primary outcome was the overall survival (OS). Secondary outcomes were extent of resection (EoR), performance status (PS), and new focal neurological deficit. Results 343 patients were included: 253 patients in 5-ALA-GS Group and 90 patients in the non-5-ALA-GS Group. The OS (17.47 versus 10.63 months, p<0.0001), post-operative PS (p<0.0001), PS at 6 months (p=0.002), new focal neurological deficit (23.3% versus 44.9%, p<0.0001) and radiological EoR (gross total resection (GTR) - 47.4% versus 22.9%, p< 0.0001) were significantly better in the 5-ALA-GS Group compared to non-5-ALA-GS Group. In multivariate analysis, use of 5-ALA (p=0.003) and MGMT promoter methylation (p=0.001) were significantly related with a better OS. In patients with radiological GTR, OS was also significantly better (p<0.0001) in the 5-ALA-GS Group compared to the non-5-ALA-GS Group. Conclusions 5-ALA guided surgery is associated with a significant improvement in the OS, PS after surgery and at six months, larger EoR, and fewer new motor deficits in patients with GBM.

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“…In recent years, an increasing number of studies have focused on the prognosis of GBM, because of its high incidence and prevalence. [17][18][19] However, LGGs (WHO Grade II/III gliomas) represent important causes of morbidity and mortality in the young adult population. 20 Some past and ongoing clinical trials (NCT02766270, NCT01164189, and NCT03906448) have also focused on LGG patients.…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Role and Nomogram Establishment of a Novel Prognostic Score Combining with Fibrinogen and Albumin Levels in Patients with WHO Grade II/III Gliomas

Jia¹,

Zhang²,

Kong³

et al. 2021

IJGM

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Purpose World Health Organization (WHO) Grades II and III gliomas [also known as low grade gliomas (LGGs)] displayed different malignant behaviors and survival outcomes compared to Grade IV gliomas. This study aimed to identify the prognostic predictive value of a novel cumulative prognostic score [combined with fibrinogen and albumin levels (FA score)], establish and validate a point-based nomogram in LGG patients. Patients and Methods A total of 91 patients who underwent total glioma resection at Shengjing Hospital of China Medical University between 2011 and 2013 were enrolled to establish a prognostic nomogram. All patients were histologically diagnosed as grades II/III, and never received radiotherapy or chemotherapy before surgery. Data collection included patient characteristics, clinicopathological factors, and preoperative hematology results. The performance of the nomogram was subsequently validated by the concordance index (c-index), calibration curve, and receiver operating characteristic (ROC) curve. Results The FA score was negatively associated with the overall survival (OS) of LGG patients (p < 0.001). The results of multivariate analysis showed that FA score [p = 0.006, HR = 1.92, 95% confidence interval (CI): 1.21–3.05], age (p = 0.002, HR = 3.014, 95% CI:1.52–5.97), and white blood count (p < 0.001, HR = 4.24, 95% CI: 2.08–8.67) were independent prognostic factors for overall survival (OS). The study established a nomogram to predict OS with a c-index of 0.783 (95% CI, 0.72–0.84). Conclusion FA score might be a potential prognostic biomarker for LGG patients, and a reliable point-based nomogram will help clinicians to decide on the best treatment plans.

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The prognostic value of peri-operative neurological performance in glioblastoma patients

Cited by 20 publications

References 30 publications

Preoperative Predictors of Early Mortality Risk in Isocitrate Dehydrogenase-Wild-Type Glioblastoma Patients Treated with Standard Therapy

Preoperative Predictors of Early Mortality Risk in Isocitrate Dehydrogenase-Wild-Type Glioblastoma Patients Treated with Standard Therapy

5-Aminolevulinic acid-guided resection improves the overall survival of patients with glioblastoma—a comparative cohort study of 343 patients

The Prognostic Role and Nomogram Establishment of a Novel Prognostic Score Combining with Fibrinogen and Albumin Levels in Patients with WHO Grade II/III Gliomas

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