Prognostic factors in patients with glioblastoma multiforme (clinical research)

Aim: To define the independent variables that affect the life spans of patients with glioblastoma multiforme (GBM). Materials and methods: This study was conducted in the neurosurgery clinic of Erciyes University’s Faculty of Medicine, lasting from February 2000 to September 2006. A total of 98 patients were diagnosed with GBM after tumor resections. Patients’ demographic, neurological, radiological, surgical, and clinical features and adjunct therapies were analyzed retrospectively. Results: Of the 98 patients, 36 (36.7%) were female and 62 (65.4%) were male. There were 15 patients (15.3%) still alive. The median survival time (MST) of the gross total resection and subtotal resection groups was 12 and 8 months, respectively. The group with postoperative Karnofsky performance scores (KPS) of ≥70 included 56 patients; their survival rate was 19.6% and their MST was 14 months (confidence interval [CI] 95%, 10–18). The postoperative KPS of <70 group included 42 patients; their MST was 4 months (CI 95%, 3–6) and their survival rate was 9.5%. After the radiotherapy, of the 73 patients who underwent chemotherapy, the survival rate was 19.2% and the MST was 14 months (CI 95%, 10–18). The group without chemotherapy had a MST of 2 months (CI 95%, 1–3) and a survival rate of 4%. In a univariate analysis, the MST of age groups I (<45), II (45–59), and III (≥60) were 15 months (CI 95%, 7–23), 10 months (CI 95%, 7–13), and 5 months (CI 95%, 3–7), respectively. The preoperative and postoperative median tumor volume detected was 79 (14–668) and 6 (0–64) mm3, respectively. Conclusion: Multivariate Cox regression analyses showed that prognostic factors are young age, postoperative KPS, chemotherapy, and postoperative tumor volume.Aim: To define the independent variables that affect the life spans of patients with glioblastoma multiforme (GBM). Materials and methods: This study was conducted in the neurosurgery clinic of Erciyes University’s Faculty of Medicine, lasting from February 2000 to September 2006. A total of 98 patients were diagnosed with GBM after tumor resections. Patients’ demographic, neurological, radiological, surgical, and clinical features and adjunct therapies were analyzed retrospectively. Results: Of the 98 patients, 36 (36.7%) were female and 62 (65.4%) were male. There were 15 patients (15.3%) still alive. The median survival time (MST) of the gross total resection and subtotal resection groups was 12 and 8 months, respectively. The group with postoperative Karnofsky performance scores (KPS) of ≥70 included 56 patients; their survival rate was 19.6% and their MST was 14 months (confidence interval [CI] 95%, 10–18). The postoperative KPS of <70 group included 42 patients; their MST was 4 months (CI 95%, 3–6) and their survival rate was 9.5%. After the radiotherapy, of the 73 patients who underwent chemotherapy, the survival rate was 19.2% and the MST was 14 months (CI 95%, 10–18). The group without chemotherapy had a MST of 2 months (CI 95%, 1–3) and a survival rate of 4%. In a univariate analysis, the MST of age groups I (<45), II (45–59), and III (≥60) were 15 months (CI 95%, 7–23), 10 months (CI 95%, 7–13), and 5 months (CI 95%, 3–7), respectively. The preoperative and postoperative median tumor volume detected was 79 (14–668) and 6 (0–64) mm3, respectively. Conclusion: Multivariate Cox regression analyses showed that prognostic factors are young age, postoperative KPS, chemotherapy, and postoperative tumor volume

Düşük dereceli astrositomlarda kötücül dönüşüm ve ilişkili faktörler

AMAÇ: Düşük dereceli astrositomlarda prognostik faktörlerin retrospektif olarak araştırılması. YÖNTEM ve GEREÇLER: Bu çalışmada, Erciyes Üniversitesi Tıp Fakültesi Nöroşirurji Kliniği’nde Mayıs 1998 ile Aralık 2005 tarihleri arasında kraniyotomi sonrası düşük dereceli astrsositom tanısı almış toplam 67 olgunun prospektif olarak tanımlanan ve prognoz üzerine etkin olabileceği varsayılan prognostik faktörler incelendi. Olguların demografik, nörolojik, radyolojik, cerrahi ve klinik özellikleri ile adjuvan tedavilerinin prognostik kriterler olarak değerlendirmesi ve prognozla olan ilişkileri incelendi. Olguların operasyona alındığı tarihten sonraki kümülatif yaşam süresi, Kaplan-Meier yöntemi kullanılarak belirlendi. Alt gruplara ait hayatta kalış süresi eğrisi, Log Rank testi kullanılarak karşılaştırıldı. Cox regresyon yöntemiyle, olguların hayatta kalışlarına ilişkin çoklu değişkenlerin etkisi analiz edildi. BULGULAR: Subtotal rezeksiyon grubunun 9 hastasında kötücül dönüşüm görüldü, fark istatistiksel olarak anlamlıydı(<0,01). Bir bayan (%3,2) ve 8 erkek (%22,2) hastada kötücül dönüşüm tespit edildi aradaki fark istatistiksel olarak anlamlıydı (P<0,05). Postoperatif radyoterapi verilen 7 hastada kötücül dönüşüm tespit edilirken radyoterapi almayan grupta sadece 2 hastada tespit edildi, gruplar arası karşılaştırmada istatistiksel anlamlı fark ortaya çıktı (P=0,01). SONUÇ: Radyoterapi alan olgularla, almayanlar kıyaslandığında malign dönüşümün radyoterapi alanlarda daha fazla görülmesi ve istatistiksel olarak farklılığın anlamlı olması radyoterapiyle ilgili tedavi planlarını yeniden gözden geçirmemizi gerektirmektedir.AIM: Retrospective investigation of prognostic factors in low-grade astrocytomas. MaterIal and Methods: In the study, prognostic factors were prospectively identified and assumed to be effective on prognosis, which were reviewed in 67 cases diagnosed as low-grade astrocytoma with craniotomy between May 1998 to December 2005 at Erciyes University Neurosurgery Department. Assessment of demographic, neurologic, radiological, surgical and clinical features of cases and adjuvant therapies and their relationship with prognosis were evaluated. Post-operative cumulative survival of the cases was estimated by using the Kaplan-Meier method. The Log Rank test was used to compare the survival curve of the sub-groups. Multivariate analysis of survival was analyzed by using the Cox regression method. Results: It was seen that malign transformation occurred in 9 patients of subtotal resection group. The difference was statistically significant (p&lt;0.01). malign transformation was detected in one female (3.2%) and 8 male patients (22.2%). Difference in favor of men was statistically significant (p&lt;0.05). Malignant transformation was detected in 7 of the patients given post-operative radiotherapy, only 2 patients displayed malign transformation in the group which received no radiotherapy. Comparison of groups revealed a significant difference (p=0.01). ConclusIon: Detection of higher malign transformation rate in cases underwent radiotherapy than those did not and the statistical significance in this meaning mandates to revise treatment plan regarding radiotherapy