gms | German Medical Science

71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Prognosis of patients with inoperable glioblastoma undergoing biopsy – Who benefits from adjuvant radiation and/or chemotherapy?

Patienten mit inoperablen, biopsierten Glioblastomen – Wer profitiert von einer adjuvanten Bestrahlung und/oder Chemotherapie?

Meeting Abstract

  • presenting/speaker Vesna Malinova - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Katja Döring - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Dorothee Mielke - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Veit Rohde - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Hans Christoph Bock - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV003

doi: 10.3205/20dgnc003, urn:nbn:de:0183-20dgnc0035

Veröffentlicht: 26. Juni 2020

© 2020 Malinova et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Patients with inoperable glioblastoma (GBM) have usually a worse prognosis compared to those with a gross total tumor resection (GTR). Tumor biopsy (TB) is performed in these patients in order to establish the histological diagnosis and to plan the adjuvant treatment, consisting of radio-chemotherapy (R-CH). Considering the duration of treatment and possible side effects, the identification of patients who will probably benefit from the treatment is essential in order to facilitate the best achievable quality of life in these patients. The aim of this study was to evaluate clinical, molecular and imaging criteria associated with a better outcome after R-CH in patients with biopsied GBMs.

Methods: Consecutive patients with inoperable GBM, who underwent TB and R-CH (Stupp protocol) at our hospital from 2008 to 2018 were retrospectively included in the study. All patients had histologically confirmed GBM and subsequently underwent follow-up until death. The overall survival (OS) was calculated from the date of diagnosis to the date of death. Clinical, radiological and molecular predictors of OS and PFS were evaluated. The data were analyzed using the programming language and software distribution Python 3.7 (Python Software Foundation, Wilmington, Delaware). Survival analysis was done using Kaplan–Meier curve and significance determined by the log-rank test. Significant factors affecting survival were then processed in multivariate analysis using Cox’s regression test. p-value <0.05 was considered significant.

Results: A total of 108 patients were enrolled in the study. The mean age was 65.0 years (range 31-88), 56.5% (61/108) were male and 43.5% (47/108) female. The mean postoperative Karnofsky status was 68.6% (range 30-100). The mean OS was 8.5 months (range 1-88). The following predictors of OS could be identified: age (p=0.0007), Ki67 (p<0.0001), positive Olig2 (p=0.04) and adjuvant treatment according to the Stupp protocol (p<0.0001). Imaging findings considering tumor localization were not a significant predictor.

Conclusion: The results of this study confirmed a survival benefit of R-CH in patients with inoperable GBM, whereas a younger age at diagnosis and a lower proliferation index were associated with a significantly longer OS. Also, Olig2 positive tumors were associated with longer OS under R-CH. A possible explanation might be a higher oligodendroglial involvement, which results in a less aggressive tumor behavior.