Impact of initial midline shift in glioblastoma on survival

Wach, Johannes; Hamed, Motaz; Schuss, Patrick; Güresir, Erdem; Herrlinger, Ulrich; Vatter, Hartmut; Schneider, Matthias

doi:10.1007/s10143-020-01328-w

Cited by 12 publications

(18 citation statements)

References 39 publications

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“…Patients (n = 208) were excluded for the following reasons: only conventional stereotactic or VarioGuide (BrainLAB AG, Feldkirchen, Bavaria, Germany) biopsies without additional cytoreductive surgeries were performed, multiple intracranial lesions were present, the patients had partial or no clinical follow-up (≥1 month), the patients underwent surgery for recurrent GBM, and the patients had no availability of baseline serum CRP or plasma fibrinogen (Figure 1). A biopsy was performed if lesions were detected within the thalamus, internal capsule, splenium of the corpus callosum or brainstem; if an MRI revealed multiple or bilateral disease; or if the functional status was graded as KPS <60% (21).…”

Section: Study Design and Patient Characteristicsmentioning

confidence: 99%

“…Afterward, the resection cavity was examined using 5aminolevulinic acid (5-ALA) (20 mg/kg, Gliolan; Medac GmbH, Wedel, Hamburg, Germany), and areas that were suspected to contain remaining tumor tissue were demarcated and resected. Post-operative MRIs were obtained within 72 h after surgery by a senior neuroradiologist to determine the extent of the resection (21). Gross total resection was defined as a resection without residual Gd-enhancement, whereas subtotal resection was considered any resection with residual Gd-enhancement and an extent of resection ≥90% (22).…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…For this purpose, paraffin sections were stained with hematoxylin and eosin (H&E). Sections were investigated immunohistochemically with Molecular Immunology Borstel-I (MIB-I) antibody, glial fibrillary acidic protein (GFAP), and IDH1 (21). MGMT status was and reported according to Hegi et al (6).…”

Section: Histopathologymentioning

confidence: 99%

“…Tumor characteristics were analyzed based on a measurement of the midline shift, tumor area, maximum extent of the peritumoral oedema, and location classified according to the topography using the Sawaya grading system (25)(26)(27)(28)(29). Definitions and measurements of the features pertaining to tumor morphology were described in our previous study (21).…”

Section: Tumor Characteristicsmentioning

confidence: 99%

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Baseline Serum C-Reactive Protein and Plasma Fibrinogen-Based Score in the Prediction of Survival in Glioblastoma

et al. 2021

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Objective: The present study investigates a score based on baseline C-reactive protein (CRP) and fibrinogen values (FC score) in 173 consecutive glioblastoma (GBM) patients.Methods: The optimal cut-off value for fibrinogen and CRP was defined as 3.5 g/dl and 3.0 mg/L, respectively, according to previous reports. Patients with elevated CRP and fibrinogen were classified with a score of 2, those with an elevation of only one of these parameters were allocated a score of 1, and those without any abnormalities were assigned a score of 0.Results: No significant differences in age, gender, tumor area, molecular pathology, physical status, or extent of resection were identified among the three groups defined by this score. Univariate survival analysis demonstrated that a high baseline FC score (≥1) is significantly associated with a shortened overall survival (OS) (HR: 1.52, 95% CI: 1.05–2.20, p = 0.027). A multivariate Cox regression analysis considering age (>65/≤65), extent of resection (GTR/STR), MGMT promoter status (hypermethylated/non-hypermethylated), and FC score (0/≥1) confirmed that an elevated FC score (≥1) is an independent predictor of shortened OS (HR: 1.71, 95% CI: 1.16–2.51, p = 0.006).Conclusions: The baseline fibrinogen and CRP score thus serves as an independent predictor of OS in GBM. Further investigations of the role of inflammation in the prediction of a prognosis are needed.

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Section: Study Design and Patient Characteristicsmentioning

confidence: 99%

Section: Surgical Proceduresmentioning

confidence: 99%

Section: Histopathologymentioning

confidence: 99%

Section: Tumor Characteristicsmentioning

confidence: 99%

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Baseline Serum C-Reactive Protein and Plasma Fibrinogen-Based Score in the Prediction of Survival in Glioblastoma

et al. 2021

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“…Paraffin sections were stained with hematoxylin and eosin (H&E). Sections were examined immunohistochemically with Molecular Immunology Borstel-I (MIB-I) antibody, glial fibrillary acidic protein (GFAP), and IDH1 (19). MGMT status was determined by methylation-specific polymerase chain reaction (PCR) and reported according to Hegi et al (5).…”

Section: Immunohistochemistrymentioning

confidence: 99%

Mean Platelet Volume/Platelet Count Ratio and Risk of Progression in Glioblastoma

et al. 2021

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ObjectiveThe mean platelet volume/platelet count (MPV/PC) ratio is an emerging biomarker in selected types of cancer. The objective of this study is to analyze the association of MPV/PC ratio with progression and survival in glioblastoma (GB) patients, with consideration of patient demographics, tumor morphology, extent of resection, molecular pathology, and oncological therapy.MethodsOne hundred ninety-one patients with newly diagnosed GB were analyzed retrospectively. MPV/PC ratio groups (≤ or >0.0575) were dichotomized into low-MPV/PC ratio (≤0.0575) and high-MPV/PC ratio (>0.0575) groups according to the most significant split in the log-rank test.ResultsA two-sided Fisher’s exact test showed no significant differences in the confounders between the low- and high-MPV/PC ratio groups. The median progression-free survival (PFS) was 9.0 months (95% CI=8.0–10.0) in the low-MPV/PC ratio group (n=164) and 6.0 months (95% CI=3.0–8.9) in the high-MPV/PC group (n=28) (p=0.013). Multivariate Cox regression analysis including the O-6-methylguanine-DNA methyltransferase (MGMT) status, age (≤/>65 years), baseline Karnofsky Performance Status (KPS), and MPV/PC ratio showed high-MPV/PC ratio as a predictor of progression (p =0.04, HR=1.61, 95% CI=1.01–2.57). In the subgroup of IDH1 wild-type GBs, high MPV/PC ratio was still a significant predictor for shortened PFS (p=0.042, HR=1.60, 95% CI=1.02–2.52). MPV/PC ratio showed no significant effect in the overall survival (OS) analysis. Median OS was 15.0 months in the high-MPV/PC ratio group and 21.0 months in the low-MPV/PC ratio group (p=0.22).ConclusionMPV/PC ratio may independently predict the progression-free survival rates of patients with glioblastoma multiforme.

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Risk Factor–Guided Early Discharge and Potential Resource Allocation Benefits in Patients with Traumatic Subarachnoid Hemorrhage

Nair

Xia

et al. 2022

World Neurosurgery

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Impact of initial midline shift in glioblastoma on survival

Cited by 12 publications

References 39 publications

Baseline Serum C-Reactive Protein and Plasma Fibrinogen-Based Score in the Prediction of Survival in Glioblastoma

Baseline Serum C-Reactive Protein and Plasma Fibrinogen-Based Score in the Prediction of Survival in Glioblastoma

Mean Platelet Volume/Platelet Count Ratio and Risk of Progression in Glioblastoma

Risk Factor–Guided Early Discharge and Potential Resource Allocation Benefits in Patients with Traumatic Subarachnoid Hemorrhage

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