Prognostic Factors in Long-Term Survivors with Glioblastoma

ABSTRACT

OBJECTIVE: The authors analyze the clinical characteristics of the long-term survivors and elucidate the biological factors responsible for long-term survival. METHODS: The 166 cases of histologically confirmed glioblastoma from Jan 1983 to Aug 1999 were included. Medical records and radiological findings were reviewed to analyze age, performance status, location and number of the tumor, the amount of peri-tumoral edema, the extent of surgical resection and history of radiation and/or chemotherapy. The overall survival was 13.6 months and the 1-year survival rate was 59%. The thirteen patients(6.9%), lived more than three years after diagnosis, defined as the long-term survivors. RESULTS: Performance status(KPS>or=70), number of masses(single with no CSF seeding), and hemispheric location(not involving basal ganglia and/or brain stem) showed favorable influence on the patient survival in univariate analysis. Also post-operative radiation and chemotherapy resulted in significant improvement of the survival. However, in multivariate analysis, age(under 40 years) was the most significant prognostic factor. All the other factors which was significant in univariate analysis except the location of the tumor, also verified as significant prognostic factors in multivariate analysis. The long-term survivors had at least more than five out of seven significant prognostic factors in multivariate analysis. And these factors occurred more frequently and showed significances in the long-term survivors than the other patient group except the debulking surgery. CONCLUSION: The age at the diagnosis and invasiveness resulted in multiple tumor and/or CSF seeding were the most significant prognostic factors.