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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Volumetric analysis and survival in patients with glioblastoma

Meeting Abstract

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  • Jens Gempt - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • Haidar El Hakim - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • Stefanie Hüttinger - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • Julia Gerhardt - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • Yu-Mi Ryang - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • Bernhard Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • Florian Ringel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMO.16.01

doi: 10.3205/14dgnc089, urn:nbn:de:0183-14dgnc0894

Published: May 13, 2014

© 2014 Gempt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Patients with glioblastoma show a poor prognosis in spite of aggressive therapeutic regimens with radical surgical resection, radiation and chemotherapy. Tumor-volume and extent of resection in patients with glioblastomas are assumed to be an important factor influencing survival. We aimed to assess influence of tumor volume in different imaging modalities on patient's survival.

Method: Patients harboring intracranial glioblastomas undergoing surgical therapy (resection and/or biopsy) between 11/2008 and 2/2012 were included. Pre- and postoperative tumor-volume was assessed by semiautomatic segmentation in MRI as well as in FET-PET for the tracer standardized uptake ratio of 1.3, 1.6, and 2.0 for a subgroup of patients. In addition, clinical data including overall survival was recorded as well.

Results: 183 pts with glioblastomas were included, mean pts age was 59 years (27-83), 71 were female and 112 male. Mean preoperative Karnofsky Performance Status Scale Index (KPS) was 76%. 165 patients underwent tumor resection; the remaining patients were biopsied only. All patients received preoperative MRI, and all patients undergoing tumor resection received early postoperative MRI except 8 patients. 125 patients received preoperative FET-PET and 57 patients postoperative FET-PET. Median survival of all patients was 9 months. Mean preoperative tumor-volume according to MRI was 28.4 cm3 and 43.7 cm3 according to FET-PET using an uptake ratio of 1.6. Mean postoperative tumor-volume was 1.2 cm3 according to MRI and 11.0 cm3 according to FET-PET. Regarding preoperative tumor volume measured with FET-PET (1.6 uptake ratio) tumors below 11.2 cm3 show a median survival of 20 month while tumors above 11.2 cm3 had a median survival of 10 months (p=0.02) Patients with no tumor visible in postoperative MRI (n=75) had a median survival of 14 months while patients with residual tumor showed a median survival of 7 months (p<0.01). Regarding the postoperative FET-PET only a trend and no statistical significant influence of tumor-volume on survival was disclosed.

Conclusions: Pre- and postoperative tumor volumes have a strong influence on overall survival in patients with glioblastomas. FET-PET might provide additional information though influence of residual tumor volume assessed by FET-PET on overall survival could not be displayed clearly.