Preoperative 2D size of glioblastoma is associated with patient survival.

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Preoperative 2D size of glioblastoma is associated with patient survival.

World Neurosurg. 2018 Apr 17;:

Authors: Leu S, Boulay JL, Thommen S, Bucher HC, Stippich C, Mariani L, Bink A

Abstract
BACKGROUND: Although tumor size impacts survival of lower-grade glioma patients, a prognostic effect on glioblastoma patients remains to be established.
METHODS: We performed a retrospective analysis of 61 patients using volumetric data of tumor compartments of 61 patients obtained by preoperative magnetic resonance images [MRI] using the visual ABC/2-method. Preoperative enhancing-, non-enhancing-, necrosis-, and edema-volume, the preoperative tumor area [TA] as product of the two largest tumor diameters perpendicular to each other on axial T1w post contrast images, as well as postoperative enhancing residual volumes, were measured. Multivariable cox proportional hazard models were used to associate these parameters with overall survival [OS] while adjusting for potential confounders.
RESULTS: The median preoperative enhancing tumor volume was 18.2 ml (IQR 8.2-41.7); the median remnant tumor volume was 1.3% (IQR 0.0%-42.9%). During follow up, 59 patients (92%) died; median survival time and median follow up time were both 404 days. We found a statistically significant multiplicative effect of TA on survival: the hazard ratio [HR] was increased by 1.096 per unit increase of 200 mm2 (95%-confidence interval [CI]: 1.027-1.170; p-value < 0.01). The effect of remnant tumor on HR increased multiplicatively by 1.013 (95%-CI: 1.001-1.026; p-value = 0.04) per unit increase of one log [day] and 1% in tumor remnant. Hazard ratio [HR] associated with age at surgery increased by 1.503 per five years of age (95%-CI: 1.243-1.817; p-value < 0.01).
CONCLUSIONS: Preoperative TA proved to be the only glioblastoma size parameter that impacts patient survival.

PMID: 29678715 [PubMed - as supplied by publisher]

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