Predictors of survival in patients with glioblastomas of the cerebral hemispheres
Keywords:glioblastoma, cerebral hemispheres, surgery, gross-total resection, adjuvant therapy, survival Kaplan-Meier
Objective: to determine the main prognostic factors of the survival of patients with glioblastomas (GLB) of the cerebral hemispheres.
Materials and methods. A prospective study of treatment outcomes of patients with GLB examined and treated in Mechnikov Dnipropetrovsk Regional Clinical Hospital from 2009 to 2014 inclusive. The studies were consecutively included 77 patients with GLB operated by the first treater. There were distinguished 4 types of neoplasm removal by the removed tumor volume: gross-total resection (GTR); near-total resection (NTR); sub-total resection (STR); partial resection (PR).
Results. There were 47 women and 30 men of the 77 patients with GLB aged from 21 to 72 years; average age was 51.9 ± 12.6 years. The cases were distributed by the tumor volume removed as follows: GTR – 20, NTR – 32, STR – 13, PR – 12 cases. Thus, advanced radical surgery (GTR + NTR) was performed in 52 (67.5%) cases.
Median survival in the total group of patients (n=77) was 353.5 days (11.6 months). The best results were achieved mostly in the young patients. The median survival of patients with GLB aged 21-40 years was 21.3 months. The use of adjuvant therapy leads to significant increase in life expectancy of patients. The median survival rate for GLB removal followed by radiotherapy was 16.1 months, and for combined treatment — 18.2 months. When removing GLB, which does not spread to functionally important and deep parts of the brain, one should try to perform GTR, which ensures long-term survival. The median survival of patients after GTR was 22.3 months.
Conclusions. The main statistically significant prognostic factors of survival of patients revealed were patients’ age (p=0.004), the tumor volume removed (p=0.00001), the presence and character of adjuvant therapy (p=0.00002).
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