Relation between extended resection and prognosis of primary glioblastoma / 中华神经医学杂志

ABSTRACT

Objective:To explore the relation between extended resection and prognosis of primary glioblastoma.Methods:A prospective study was performed. The subjects were from the colony of patients with primary glioblastoma who underwent surgical resection in our hospital from January 2014 from January 2017. Tumor volume and tumor residual volume showed by MR imaging T1 enhanced sequences (Group A and Group B), and tumor volume and tumor residual volume showed by fluid-attenuated inversion recovery (FLAIR) sequences (Group A1 and Group A2) were obtained within one week before surgery and 24 h after surgery, respectively; and the degrees of tumor resection were calculated. Cox proportional hazards regression model was used to determine factors influencing overall survival (OS) in glioblastoma patients. Kaplan-Meier method was used to plot the survival curves of these patients. Log-rank test was used to compare the survival rates of patients from Group A and Group B, and patients from Group A1 and Group A2.Results:A total of 128 patients were included; 71(55.5%) were into Group A, and 17 (13.3%) were into Group A1. Multivariate analysis showed that preoperative Karnofsky performance scale (KPS) scores, promoter methylation status of O-6-methylguanine-DNA methyltransferase (MGMT), tumor residual volume by T1 enhanced sequences, tumor residual volume by FLAIR sequences, and tumor resection degree by FLAIR sequences were independent influencing factors for OS ( P<0.05). Survival rate of patients from Group A was significantly higher than that in Group B( P<0.05); and survival rate of patients from Group A1 was significantly higher than that in Group A2 ( P<0.05). Conclusion:Residual of primary glioblastoma showed by FLAIR sequences is an important factor affecting the prognoses, and extended resection is necessary.