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01-08-2018 | Clinical Study

Multi-center study finds postoperative residual non-enhancing component of glioblastoma as a new determinant of patient outcome

Authors: Aikaterini Kotrotsou, Ahmed Elakkad, Jia Sun, Ginu A. Thomas, Dongni Yang, Srishti Abrol, Wei Wei, Jeffrey S. Weinberg, Ali S. Bakhtiari, Moritz F. Kircher, Markus M. Luedi, John F. de Groot, Raymond Sawaya, Ashok J. Kumar, Pascal O. Zinn, Rivka R. Colen

Published in: Journal of Neuro-Oncology | Issue 1/2018

Abstract

Introduction

The aim of the present study is to assess whether postoperative residual non-enhancing volume (PRNV) is correlated and predictive of overall survival (OS) in glioblastoma (GBM) patients.

Methods

We retrospectively analyzed a total 134 GBM patients obtained from The University of Texas MD Anderson Cancer Center (training cohort, n = 97) and The Cancer Genome Atlas (validation cohort, n = 37). All patients had undergone postoperative magnetic resonance imaging immediately after surgery. We evaluated the survival outcomes with regard to PRNV. The role of possible prognostic factors that may affect survival after resection, including age, sex, preoperative Karnofsky performance status, postoperative nodular enhancement, surgically induced enhancement, and postoperative necrosis, was investigated using univariate and multivariate Cox proportional hazards regression analyses. Additionally, a recursive partitioning analysis (RPA) was used to identify prognostic groups.

Results

Our analyses revealed that a high PRNV (HR 1.051; p-corrected = 0.046) and old age (HR 1.031; p-corrected = 0.006) were independent predictors of overall survival. This trend was also observed in the validation cohort (higher PRNV: HR 1.127, p-corrected = 0.002; older age: HR 1.034, p-corrected = 0.022). RPA analysis identified two prognostic risk groups: low-risk group (PRNV < 70.2 cm³; n = 55) and high-risk group (PRNV ≥ 70.2 cm³; n = 42). GBM patients with low PRNV had a significant survival benefit (5.6 months; p = 0.0037).

Conclusion

Our results demonstrate that high PRNV is associated with poor OS. Such results could be of great importance in a clinical setting, particularly in the postoperative management and monitoring of therapy.

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Title: Multi-center study finds postoperative residual non-enhancing component of glioblastoma as a new determinant of patient outcome
Authors: Aikaterini Kotrotsou
Ahmed Elakkad
Jia Sun
Ginu A. Thomas
Dongni Yang
Srishti Abrol
Wei Wei
Jeffrey S. Weinberg
Ali S. Bakhtiari
Moritz F. Kircher
Markus M. Luedi
John F. de Groot
Raymond Sawaya
Ashok J. Kumar
Pascal O. Zinn
Rivka R. Colen
Publication date: 01-08-2018
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 1/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2850-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Multi-center study finds postoperative residual non-enhancing component of glioblastoma as a new determinant of patient outcome

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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