gms | German Medical Science

Objective: Dismal Glioblastoma (GB) patient outcome calls for elucidation of further reliable predictors of prognosis. Established "biomarkers"; age and functional status, employed in today's patient stratification have limits in fingerprinting this heterogeneous tumor entity. We aimed at ascertaining additional prognostic factors, which may facilitate patient stratification for surgery.

Method: A retrospective review of 233 consecutive adult patients operated on for newly diagnosed GB at a single tertiary institution over a 5-year-period (2006-2011) was conducted. Modern defined outcome associating factors recorded included demographic's (preoperative age, gender, signs, symptoms, comorbidity status quantified by the Charlson-comorbidity-index (CCI), functional status computed by the Karnofsky Performance Scale (KPS), tumor characteristics (size, location, Isocitrate dehydrogenase (IDH)-1 mutation and O6-methylguanine-DNA methyltransferase (MGMT)-Promotor-methylation-status) and treatment parameters (volumetrically quantified extent of resection and adjuvant therapy). Survival analysis was performed by the Kaplan-Maier-Method. Influence of variables was evaluated using Log-rank test.

Results: Median neuroradiographic evidence of tumor progression was found 6 months after surgery (range 0-72). The median overall survival was 9.5 months (range 0-72). Age >65 years, KPS ≤70 and CCI >3 were significantly associated with both poor OS (each p<0.0001) and PFS (p<0.0001, p<0.001 and p<0.002) respectively. Also patients older than 65 years significantly had a CCI >3 (p<0.0001).

Conclusions: Our data evidences that aside from established prognostic parameters (age and KPS) for GB patient outcome, the CCI also significantly impacts outcome and may be employed for preoperative patient stratification.