Johannes Dietterle1, Tim Wende2, Florian Wilhelmy2, Christian Eisenlöffel3, Katja Jähne2, Sabine Taubenheim4, Felix Arlt2, Jürgen Meixensberger2. 1. Department of Neurosurgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. johannes.dietterle@medizin.uni-leipzig.de. 2. Department of Neurosurgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. 3. Department of Pathology, University Hospital Leipzig, Liebigstraße 26, 04103, Leipzig, Germany. 4. Leipzig Cancer Registry, University Hospital Leipzig, Philipp-Rosenthal-Straße 27b, 04103, Leipzig, Germany.
Abstract
BACKGROUND: IDH-wild-type glioblastoma (GBM) is a disease with devastating prognosis. First-line therapy consists of gross total resection and adjuvant radiotherapy with concomitant temozolomide. Several clinical parameters have been identified to provide prognostic value. We investigated whether peri-operative overall neurological performance could also be used to evaluate patients' prognosis. METHODS: All patients with histologically diagnosed GBM between 2014 and 2017 over 18 years and MRI within 72 h after surgery were reviewed. To quantify neurological performance, the medical research council neurological performance score (MRC-NPS) was used. Univariate analysis with Kaplan-Meier estimate and log-rank test was performed. Survival prediction and multivariate analysis were performed employing Cox proportional hazard regression. RESULTS: One hundred thirty-nine patients were included. In univariate analysis, survival decreased with increasing post-operative MRC-NPS scale. Moreover, post-operative MRC-NPS of 4 was statistically significant associated with reduced overall survival when analyzed for complete (p = 0.027) and partial resection (p = 0.002) as well as unilobar (p = 0.003) and multilobar tumor location (p < 0.0005). In multivariate analysis, extent of resection (hazard ratio (HR) 3.142), adjuvant therapy regimen (HR 3.001), tumor location (HR 2.005), and post-operative MRC-NPS (HR 2.310) had significant influence on overall survival. CONCLUSION: We propose the post-operative neurological performance as an independent prognostic factor for GBM patients.
BACKGROUND:IDH-wild-type glioblastoma (GBM) is a disease with devastating prognosis. First-line therapy consists of gross total resection and adjuvant radiotherapy with concomitant temozolomide. Several clinical parameters have been identified to provide prognostic value. We investigated whether peri-operative overall neurological performance could also be used to evaluate patients' prognosis. METHODS: All patients with histologically diagnosed GBM between 2014 and 2017 over 18 years and MRI within 72 h after surgery were reviewed. To quantify neurological performance, the medical research council neurological performance score (MRC-NPS) was used. Univariate analysis with Kaplan-Meier estimate and log-rank test was performed. Survival prediction and multivariate analysis were performed employing Cox proportional hazard regression. RESULTS: One hundred thirty-nine patients were included. In univariate analysis, survival decreased with increasing post-operative MRC-NPS scale. Moreover, post-operative MRC-NPS of 4 was statistically significant associated with reduced overall survival when analyzed for complete (p = 0.027) and partial resection (p = 0.002) as well as unilobar (p = 0.003) and multilobar tumor location (p < 0.0005). In multivariate analysis, extent of resection (hazard ratio (HR) 3.142), adjuvant therapy regimen (HR 3.001), tumor location (HR 2.005), and post-operative MRC-NPS (HR 2.310) had significant influence on overall survival. CONCLUSION: We propose the post-operative neurological performance as an independent prognostic factor for GBMpatients.
Authors: Johannes Kasper; Nicole Hilbert; Tim Wende; Michael Karl Fehrenbach; Florian Wilhelmy; Katja Jähne; Clara Frydrychowicz; Gordian Hamerla; Jürgen Meixensberger; Felix Arlt Journal: Curr Oncol Date: 2021-04-07 Impact factor: 3.677
Authors: Johannes Kasper; Tim Wende; Michael Karl Fehrenbach; Florian Wilhelmy; Katja Jähne; Clara Frydrychowicz; Gordian Prasse; Jürgen Meixensberger; Felix Arlt Journal: Front Oncol Date: 2021-12-02 Impact factor: 6.244
Authors: Caroline Sander; Clara Frydrychowicz; Gordian Prasse; Sabine Taubenheim; Felix Arlt; Jürgen Meixensberger; Michael Karl Fehrenbach Journal: BMC Cancer Date: 2022-03-28 Impact factor: 4.430
Authors: Asfand Baig Mirza; Ioannis Christodoulides; Jose Pedro Lavrador; Anastasios Giamouriadis; Amisha Vastani; Timothy Boardman; Razna Ahmed; Irena Norman; Christopher Murphy; Sharmila Devi; Francesco Vergani; Richard Gullan; Ranjeev Bhangoo; Keyoumars Ashkan Journal: Neurooncol Adv Date: 2021-03-26