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Acta Neurochirurgica
Published in: Acta Neurochirurgica 2/2020

01-02-2020 | Glioblastoma | Original Article - Brain Tumors

The prognostic value of peri-operative neurological performance in glioblastoma patients

Authors: Johannes Dietterle, Tim Wende, Florian Wilhelmy, Christian Eisenlöffel, Katja Jähne, Sabine Taubenheim, Felix Arlt, Jürgen Meixensberger

Published in: Acta Neurochirurgica | Issue 2/2020

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Abstract

Background

IDH-wild-type glioblastoma (GBM) is a disease with devastating prognosis. First-line therapy consists of gross total resection and adjuvant radiotherapy with concomitant temozolomide. Several clinical parameters have been identified to provide prognostic value. We investigated whether peri-operative overall neurological performance could also be used to evaluate patients’ prognosis.

Methods

All patients with histologically diagnosed GBM between 2014 and 2017 over 18 years and MRI within 72 h after surgery were reviewed. To quantify neurological performance, the medical research council neurological performance score (MRC-NPS) was used. Univariate analysis with Kaplan–Meier estimate and log-rank test was performed. Survival prediction and multivariate analysis were performed employing Cox proportional hazard regression.

Results

One hundred thirty-nine patients were included. In univariate analysis, survival decreased with increasing post-operative MRC-NPS scale. Moreover, post-operative MRC-NPS of 4 was statistically significant associated with reduced overall survival when analyzed for complete (p = 0.027) and partial resection (p = 0.002) as well as unilobar (p = 0.003) and multilobar tumor location (p < 0.0005). In multivariate analysis, extent of resection (hazard ratio (HR) 3.142), adjuvant therapy regimen (HR 3.001), tumor location (HR 2.005), and post-operative MRC-NPS (HR 2.310) had significant influence on overall survival.

Conclusion

We propose the post-operative neurological performance as an independent prognostic factor for GBM patients.
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Metadata
Title
The prognostic value of peri-operative neurological performance in glioblastoma patients
Authors
Johannes Dietterle
Tim Wende
Florian Wilhelmy
Christian Eisenlöffel
Katja Jähne
Sabine Taubenheim
Felix Arlt
Jürgen Meixensberger
Publication date
01-02-2020
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 2/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-019-04136-4

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