Prognosis factors of survival time in patients with glioblastoma multiforme: a multivariate analysis of 340 patients

Abstract

Using multivariate analysis, the following factors were found to influence survival: radiotherapy was the predominant factor followed by radical surgery, tumour location, age and chemotherapy. Patients treated with temozolomide had a markedly better survival rate than patients treated with other chemotherapies (Log-rank test P < 0.005). The values of GBM type (de novo or secondary), as well as repeated surgery and partial surgery (vs. simple biopsy) were suggested by univariate analysis but not confirmed by the COX regression method. After radical surgery, progression-free survival was correlated to overall survival (r = 0.87, P < 10e-5). CONCLUSIONS; The influence of radiotherapy on survival was greater than the influence of age, an argument supporting the proposition of radiotherapy for patients until at least age 70. In the case of recurrence, the correlation between overall survival and progression-free survival is an important factor when considering the therapeutic options. Initial radical surgery and repeated procedures dramatically influence survival. The benefit of partial surgery remains difficult to evaluate. Partial surgery could be used to decrease intracranial pressure and to minimize residual tumours in order to enable treatment by chemotherapy and radiotherapy. The value of temozolomide treatment was confirmed.

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“…Many other authors also believe that the total removal of GBM may influence the survival. 6,12,13,15,19 McGirt et al 13 analyzed 451 GBM patients and had 13 months of average survival of those submitted to the total resection. However, other authors did not find any relation between total removal and survival.…”

“…2) Radiotherapy -The role of RT in treating glioblastoma has already been established. 1,2,6,8,12,22 Mineo et al 15 mention radiotherapy as the factor with most influence on the prognosis independently of age, the KPS and the surgical extension. According to Barker et al 1 the radiotherapy has more influence in younger patients.…”

Effectiveness of the bevacizumab-irinotecan regimen in the treatment of recurrent glioblastoma multiforme: Comparison with other second-line treatments without this regimen

“…Certain factors that have been suggested to predict a good prognosis include age (adults under 58 years have better rates of survival and progression-free disease) (11), Karnofsky Performance Status (KPS) ≥70-80% at diagnosis (12), absence of anaplastic cells, existence of oligodendroglial elements, tumour size and type of surgical resection (complete resections have been identified to have better survival data) (13), and preserved cognitive status (10).…”

Effects of Socioeconomic on Survival for Adult Glioblastoma Multiform Patients in Rio de Janeiro, Brazil, 1999-2009

“…This study aims at comparing the survival of supratentorial adult GBM patients operated on at public hospital with that of GBM patients operated on at the private hospital and observe, if besides the previously identified prognostic factors [1][2][3][4][5][6][7] , socioeconomic factors, as previous reported by several authors, interfere in the GBM patients' survival in Brazil [8][9][10][11][12].…”