The Association Between Common Clinical Characteristics and Postoperative Morbidity and Overall Survival in Patients with Glioblastoma

Liu, Wenli; Qdaisat, Aiham; Yeung, Jason; Lopez, Gabriel; Weinberg, Jeffrey S.; Zhou, Shouhao; Cohen, Lorenzo; Bruera, Éduardo; Yeung, Sai Ching Jim

doi:10.1634/theoncologist.2018-0056

Cited by 12 publications

(15 citation statements)

References 36 publications

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“…Limitations of this study include its retrospective nature and power. The sample size is comparable to other single-institution studies, although there was a limited sample size for subgroups for some comorbidities 5,19 . This sample has a higher proportion of nonwhite patients compared to other studies on glioblastoma patients in the literature 2 .…”

Section: Discussionsupporting

confidence: 52%

“…Prior studies evaluating comorbidities and long-term survival in patients with GBM have focused on a limited number of comorbid conditions, primarily diabetes mellitus 19,37 . Additionally, the usual risk of mortality associated with hypertension, diabetes, stroke, and heart disease may be overcome by the drastically higher rate of mortality of patients within our sample population.…”

Section: Discussionmentioning

confidence: 99%

“…To date, most studies on survival 4–11 have focused on the effects of treatment modalities 12–15 or specific patient populations such as pediatrics 16 and geriatrics 17,18 . Limited research has been conducted on demographic factors, clinical characteristics, or medical comorbidities as predictors for overall survival 10,19 . A few predictors of survival are well-established, including: age, extent of resection (EOR), performance status, and O 6 -methylguanine-DNA-methyltransferase (MGMT) status 10,20,21 .…”

Section: Introductionmentioning

confidence: 99%

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Comorbid Medical Conditions as Predictors of Overall Survival in Glioblastoma Patients

Carr

Hochheimer

Rock

et al. 2019

Sci Rep

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Glioblastoma (GBM) is an aggressive central nervous system tumor with a poor prognosis. This study was conducted to determine any comorbid medical conditions that are associated with survival in GBM. Data were collected from medical records of all patients who presented to VCU Medical Center with GBM between January 2005 and February 2015. Patients who underwent surgery/biopsy were considered for inclusion. Cox proportional hazards regression modeling was performed to assess the relationship between survival and sex, race, and comorbid medical conditions. 163 patients met inclusion criteria. Comorbidities associated with survival on individual-characteristic analysis included: history of asthma (Hazard Ratio [HR]: 2.63; 95% Confidence Interval [CI]: 1.24–5.58; p = 0.01), hypercholesterolemia (HR: 1.95; 95% CI: 1.09–3.50; p = 0.02), and incontinence (HR: 2.29; 95% CI: 0.95–5.57; p = 0.07). History of asthma (HR: 2.22; 95% CI: 1.02–4.83; p = 0.04) and hypercholesterolemia (HR: 1.99; 95% CI: 1.11–3.56; p = 0.02) were associated with shorter survival on multivariable analysis. Surgical patients with GBM who had a prior history of asthma or hypercholesterolemia had significantly higher relative risk for mortality on individual-characteristic and multivariable analyses.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comorbid Medical Conditions as Predictors of Overall Survival in Glioblastoma Patients

Carr

Hochheimer

Rock

et al. 2019

Sci Rep

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“… 18 Liu et al found that lower systolic blood pressure, lower albumin, and higher blood glucose were associated with worse survival. 19 The driving factor for not only elderly patients but all patients with GBM – and likely those undergoing any type of surgery – is how systemically well these patients are and how well-controlled their comorbidities are perioperative. Elderly patients with multiple well-controlled comorbidities should still be offered surgical and adjuvant treatment for GBM.…”

Section: Discussionmentioning

confidence: 99%

Predictors of survival in elderly patients undergoing surgery for glioblastoma

Voisin

Sasikumar

Zadeh

2021

Neuro-Oncology Advances

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Background GBM has a median age of diagnosis of 64 years old and the incidence increases with age. An increasing number of elderly patients are being diagnosed with GBM and undergoing surgery. These patients often present with multiple medical comorbidities and have significantly worse outcomes compared to adult patients. The goal of this study was to determine clinical predictors of survival in elderly patients undergoing surgery for GBM. Methods Our brain tumor database was reviewed for all patients 65 years of age and older that underwent surgery for newly diagnosed GBM over a 14-year period from 2005 to 2018. Patient characteristics, comorbidities, complications, and treatment were collected. A total of 150 patients were included, and subdivided into two age categories; 65-74 years old and 75 years or older. Results The median OS for all patients was 9.4 months. Neither the presence nor number of medical comorbidities were associated with decreased survival (p = 0.9 and p = 0.1, respectively). Postoperative complications were associated with worse survival for all patients (HR = 2.34, p = 0.01) and occurred in patients in the older age category and patients with longer lengths of stay (p < 0.0001). Conclusions The presence of medical comorbidities is not a reason to exclude patients with GBM from surgical consideration. Excluding EOR and adjuvant treatment, postoperative complication is the most significant predictor of survival in elderly patients. Postoperative complications are associated with a longer LOS and are more common in patients 75 years of age and older.

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“…The postoperative serum level of albumin was associated with OS in GBM patients in univariate analysis, but it was not a predictor in multivariate analysis. Previous studies investigating the association between preoperative serum albumin concentration and prognosis of GBM reported that low serum albumin concentration was an independent poor prognostic factor [ 6 , 29 , 30 ]. Lymphocytes, which are the other component of the PNI, play a key role in cell-mediated immunity.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of the postoperative prognostic nutritional index in patients with glioblastoma: a retrospective study

Kim

Lee

et al. 2021

BMC Cancer

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Background The prognostic nutritional index (PNI) reflects immunonutritional status. We evaluated the effects of postoperative PNI and perioperative changes in the PNI on overall survival (OS) in glioblastoma (GBM) patients. Methods Demographic, laboratory, and clinical data were retrospectively collected from 335 GBM patients. Preoperative and postoperative PNIs were calculated from serum albumin concentration and lymphocyte count, which were measured within 3 weeks before surgery and 1 month after surgery. Patients were classified into high (n = 206) or low (n = 129) postoperative PNI groups according to the postoperative PNI cutoff value and further classified into four groups according to the cutoff values of the preoperative and postoperative PNIs, as follows: Group HH (both high PNIs, n = 92), Group HL (high preoperative and low postoperative PNI, n = 70), Group LH (low preoperative and high postoperative PNI, n = 37), and Group LL (both low PNIs, n = 136). Results The median OS was significantly longer in the high postoperative PNI (PNI ≥ 50.2) group than the low postoperative PNI (PNI < 50.2) group (24.0 vs. 15.0 months, p < 0.001). In multivariate analysis, high postoperative PNI was a significant predictor of OS. OS was significantly longer in Group HH than in Group LL and seemed longer in Group HH than in Group HL and in Group LH than in Group LL. OS was not different between Groups HH and LH or between Groups HL and LL. Conclusions High postoperative PNI was associated with improved OS and perioperative changes in PNI may provide additional important information for prognostic prediction in GBM patients.

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The Association Between Common Clinical Characteristics and Postoperative Morbidity and Overall Survival in Patients with Glioblastoma

Cited by 12 publications

References 36 publications

Comorbid Medical Conditions as Predictors of Overall Survival in Glioblastoma Patients

Comorbid Medical Conditions as Predictors of Overall Survival in Glioblastoma Patients

Predictors of survival in elderly patients undergoing surgery for glioblastoma

Prognostic significance of the postoperative prognostic nutritional index in patients with glioblastoma: a retrospective study

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