Abstract
Background
Using isocitrate dehydrogenase (IDH) mutations to classify survival outcomes of patients with glioblastoma multiforme was recommended based on novel histopathological classification of brain tumors. Considering this novel classification, it is unclear whether the extent of tumor resection (EOR) is still important. The aim of this study was to investigate prognostic value of clinical factors (age, sex, EOR, status of IDH mutations, and adjuvant therapy) in patients with newly diagnosed glioblastoma.
Methods
In total, 269 patients were retrospectively enrolled and randomly divided into training (n = 179) and validation (n = 90) cohorts. Clinical information and survival outcomes were acquired from inpatient records and follow-ups. After adjusting for risk coefficients, the independent prognostic factors were selected in a multivariable analysis to generate a model to evaluate survival outcomes. Additionally, a receiver operating characteristic curve was used to assess accuracy for predicting survival outcomes at 12, 15, 18, and 24 months.
Results
Total resection of the contrast-enhanced region, age ≤ 60 years, received chemotherapy, and IDH mutations were favorable independent factors for overall survival. Area under the curve (AUC) for prediction of survival in the training cohort was 0.815, 0.851, 0.849, and 0.836 at 12, 15, 18, and 24 months, respectively. In the validation cohort, the AUC for prediction of survival was 0.780, 0.807, 0.836, and 0.849 at 12, 15, 18, and 24 months, respectively.
Conclusion
Total resection of the contrast-enhanced region is still crucial and recommended for patients with glioblastoma. Our prognostic model was able to predict survival outcomes, especially for long-term survival prediction.
Correlation of TTFields Dose Density and Survival Outcomes in Newly Diagnosed Glioblastoma: A Numerical Simulation-Based Analysis of Patient Data from the EF-14 Randomized Trial.