Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale - a bicentric retrospective study
Median overall survival (OS) after diagnosis of glioblastoma (GBM) remains 15 months amongst patients receiving aggressive surgical resection, chemotherapy and irradiation. Treatment of patients with a poor preoperative Karnofsky Performance Status Scale (KPSS) is still controversial. Therefore, we...
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| creator | Barz, Melanie Gerhardt, Julia Bette, Stefanie Aftahy, A Kaywan Huber, Thomas Combs, Stephanie E Ryang, Yu-Mi Wiestler, Benedikt Skardelly, Marco Gepfner-Tuma, Irina Behling, Felix Schmidt-Graf, Friederike Meyer, Bernhard Gempt, Jens |
| description | Median overall survival (OS) after diagnosis of glioblastoma (GBM) remains 15 months amongst patients receiving aggressive surgical resection, chemotherapy and irradiation. Treatment of patients with a poor preoperative Karnofsky Performance Status Scale (KPSS) is still controversial. Therefore, we retrospectively assessed the outcome after surgical treatment in patients with a KPSS of ≤60%.
We retrospectively included patients with a de-novo glioblastoma WHO °IV and preoperative KPSS ≤60%, who underwent surgery at two neurosurgical centres between September 2006 and March 2016. We recorded pre- and postoperative tumour volume, pre- and postoperative KPSS, OS, age and MGMT promoter status.
One hundred twenty-three patients (58 females/65 males, mean age 67.4 ± 13.4 years) met the inclusion criteria. Seventy-five of the 123 patients (61%) underwent surgical resection. 48/123 patients (39%) received a biopsy. The median preoperative and postoperative tumour volume of all patients was 33.0 ± 31.3 cm
(IR 15.0-56.5cm
) and 3.1 ± 23.8 cm
(IR 0.2-15.0 cm
), respectively. The median KPSS was 60% (range 20-60%) preoperatively and 50% (range 0-80%) postoperatively. Patients who received a biopsy showed a median OS for patients who received a biopsy only was 3.0 months (95% CI 2.0-4.0 months), compared to patients who had a resection and had a median OS of 8 months (95% CI 3.1-12.9 months). Age (p |
| doi_str_mv | 10.1186/s12883-021-02424-0 |
| format | Article |
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We retrospectively included patients with a de-novo glioblastoma WHO °IV and preoperative KPSS ≤60%, who underwent surgery at two neurosurgical centres between September 2006 and March 2016. We recorded pre- and postoperative tumour volume, pre- and postoperative KPSS, OS, age and MGMT promoter status.
One hundred twenty-three patients (58 females/65 males, mean age 67.4 ± 13.4 years) met the inclusion criteria. Seventy-five of the 123 patients (61%) underwent surgical resection. 48/123 patients (39%) received a biopsy. The median preoperative and postoperative tumour volume of all patients was 33.0 ± 31.3 cm
(IR 15.0-56.5cm
) and 3.1 ± 23.8 cm
(IR 0.2-15.0 cm
), respectively. The median KPSS was 60% (range 20-60%) preoperatively and 50% (range 0-80%) postoperatively. Patients who received a biopsy showed a median OS for patients who received a biopsy only was 3.0 months (95% CI 2.0-4.0 months), compared to patients who had a resection and had a median OS of 8 months (95% CI 3.1-12.9 months). Age (p < 0.001, HR: 1.045 [95% CI 1.022-1.068]), postoperative tumour volume (p = 0.02, HR: 1.016 [95% CI 1.002-1.029]) and MGMT promotor status (p = 0.016, HR: 0.473 [95% CI 0.257-0.871]) were statistically significant in multivariate analysis. In subgroup analyses only age was shown as a significant prognostic factor in multivariate analyses for patients receiving surgery (p < 0.001, HR: 1.046 [95% CI 1.022-1.072]). In the biopsy group no significant prognostic factors were shown in multivariate analysis.
GBM patients with a preoperative KPSS of ≤60% might profit from surgical reduction of tumour burden.</description><identifier>ISSN: 1471-2377</identifier><identifier>EISSN: 1471-2377</identifier><identifier>DOI: 10.1186/s12883-021-02424-0</identifier><identifier>PMID: 34781889</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Age ; Aged ; Aged, 80 and over ; Biopsy ; Brain cancer ; Brain Neoplasms - surgery ; Care and treatment ; Chemotherapy ; Data analysis ; EOR ; Female ; Glioblastoma ; Glioblastoma - surgery ; Glioblastoma multiforme ; Humans ; Interdisciplinary aspects ; Karnofsky Performance Status ; Karnofsky performance status scale ; Magnetic resonance imaging ; Male ; Medical prognosis ; Middle Aged ; Multivariate analysis ; Neurosurgery ; Neurosurgical Procedures ; Patients ; Practice guidelines (Medicine) ; Prognosis ; Retrospective Studies ; Statistical analysis ; Surgery ; Survival analysis ; Treatment Outcome ; Tumor Burden ; Tumors</subject><ispartof>BMC neurology, 2021-11, Vol.21 (1), p.446-446, Article 446</ispartof><rights>2021. The Author(s).</rights><rights>COPYRIGHT 2021 BioMed Central Ltd.</rights><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c524t-90d58ea3fa86f46bbca71b0157910bdfd0e353a7374a19cfede3bcd6f1a261cc3</citedby><cites>FETCH-LOGICAL-c524t-90d58ea3fa86f46bbca71b0157910bdfd0e353a7374a19cfede3bcd6f1a261cc3</cites><orcidid>0000-0001-8734-9309</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591917/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591917/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34781889$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barz, Melanie</creatorcontrib><creatorcontrib>Gerhardt, Julia</creatorcontrib><creatorcontrib>Bette, Stefanie</creatorcontrib><creatorcontrib>Aftahy, A Kaywan</creatorcontrib><creatorcontrib>Huber, Thomas</creatorcontrib><creatorcontrib>Combs, Stephanie E</creatorcontrib><creatorcontrib>Ryang, Yu-Mi</creatorcontrib><creatorcontrib>Wiestler, Benedikt</creatorcontrib><creatorcontrib>Skardelly, Marco</creatorcontrib><creatorcontrib>Gepfner-Tuma, Irina</creatorcontrib><creatorcontrib>Behling, Felix</creatorcontrib><creatorcontrib>Schmidt-Graf, Friederike</creatorcontrib><creatorcontrib>Meyer, Bernhard</creatorcontrib><creatorcontrib>Gempt, Jens</creatorcontrib><title>Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale - a bicentric retrospective study</title><title>BMC neurology</title><addtitle>BMC Neurol</addtitle><description>Median overall survival (OS) after diagnosis of glioblastoma (GBM) remains 15 months amongst patients receiving aggressive surgical resection, chemotherapy and irradiation. Treatment of patients with a poor preoperative Karnofsky Performance Status Scale (KPSS) is still controversial. Therefore, we retrospectively assessed the outcome after surgical treatment in patients with a KPSS of ≤60%.
We retrospectively included patients with a de-novo glioblastoma WHO °IV and preoperative KPSS ≤60%, who underwent surgery at two neurosurgical centres between September 2006 and March 2016. We recorded pre- and postoperative tumour volume, pre- and postoperative KPSS, OS, age and MGMT promoter status.
One hundred twenty-three patients (58 females/65 males, mean age 67.4 ± 13.4 years) met the inclusion criteria. Seventy-five of the 123 patients (61%) underwent surgical resection. 48/123 patients (39%) received a biopsy. The median preoperative and postoperative tumour volume of all patients was 33.0 ± 31.3 cm
(IR 15.0-56.5cm
) and 3.1 ± 23.8 cm
(IR 0.2-15.0 cm
), respectively. The median KPSS was 60% (range 20-60%) preoperatively and 50% (range 0-80%) postoperatively. Patients who received a biopsy showed a median OS for patients who received a biopsy only was 3.0 months (95% CI 2.0-4.0 months), compared to patients who had a resection and had a median OS of 8 months (95% CI 3.1-12.9 months). Age (p < 0.001, HR: 1.045 [95% CI 1.022-1.068]), postoperative tumour volume (p = 0.02, HR: 1.016 [95% CI 1.002-1.029]) and MGMT promotor status (p = 0.016, HR: 0.473 [95% CI 0.257-0.871]) were statistically significant in multivariate analysis. In subgroup analyses only age was shown as a significant prognostic factor in multivariate analyses for patients receiving surgery (p < 0.001, HR: 1.046 [95% CI 1.022-1.072]). In the biopsy group no significant prognostic factors were shown in multivariate analysis.
GBM patients with a preoperative KPSS of ≤60% might profit from surgical reduction of tumour burden.</description><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biopsy</subject><subject>Brain cancer</subject><subject>Brain Neoplasms - surgery</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Data analysis</subject><subject>EOR</subject><subject>Female</subject><subject>Glioblastoma</subject><subject>Glioblastoma - surgery</subject><subject>Glioblastoma multiforme</subject><subject>Humans</subject><subject>Interdisciplinary aspects</subject><subject>Karnofsky Performance Status</subject><subject>Karnofsky performance status scale</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neurosurgery</subject><subject>Neurosurgical Procedures</subject><subject>Patients</subject><subject>Practice guidelines (Medicine)</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Survival analysis</subject><subject>Treatment Outcome</subject><subject>Tumor Burden</subject><subject>Tumors</subject><issn>1471-2377</issn><issn>1471-2377</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNpdkktv1DAURiMEoqXwB1ggS2zYBHwdO3Y2SFXFo6ISLGBtOX5MPSRxsJ2pZsNvx5kppWUROYrPPc69_qrqJeC3AKJ9l4AI0dSYQHkooTV-VJ0C5VCThvPH995PqmcpbTEGLig8rU4aygUI0Z1Wv7_FsJlCyl6jnRoWi4JDeRnDEtEuDMtokZ_QrLK3U07oxudrpNAcQkRfVJyCSz_3aLbRhTiqSVuUsspLQkmrwaK6sL3XpTQWf7Q5hjRbnf1uBRezf149cWpI9sXtelb9-Pjh-8Xn-urrp8uL86taM0Jz3WHDhFWNU6J1tO17rTj0GBjvAPfGGWwb1ijecKqg084a2_TatA4UaUHr5qy6PHpNUFs5Rz-quJdBeXn4EOJGqlhmMFjJDRAsLDCCGWUY986ZtuuNcoQTbXlxvT-65qUfrTl0p4YH0oc7k7-Wm7CTgnXQwSp4cyuI4ddiU5ajT9oOg5psWJIkrBNYAAZa0Nf_odtyM1MZ1UoVWcsE_kdtytCln1wo5-pVKs9b0VLWlWYKRY6ULreQonV3vwxYroGSx0DJEih5CJRci17db_au5G-Cmj9rrcjj</recordid><startdate>20211115</startdate><enddate>20211115</enddate><creator>Barz, Melanie</creator><creator>Gerhardt, Julia</creator><creator>Bette, Stefanie</creator><creator>Aftahy, A Kaywan</creator><creator>Huber, Thomas</creator><creator>Combs, Stephanie E</creator><creator>Ryang, Yu-Mi</creator><creator>Wiestler, Benedikt</creator><creator>Skardelly, Marco</creator><creator>Gepfner-Tuma, Irina</creator><creator>Behling, Felix</creator><creator>Schmidt-Graf, Friederike</creator><creator>Meyer, Bernhard</creator><creator>Gempt, Jens</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-8734-9309</orcidid></search><sort><creationdate>20211115</creationdate><title>Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale - a bicentric retrospective study</title><author>Barz, Melanie ; Gerhardt, Julia ; Bette, Stefanie ; Aftahy, A Kaywan ; Huber, Thomas ; Combs, Stephanie E ; Ryang, Yu-Mi ; Wiestler, Benedikt ; Skardelly, Marco ; Gepfner-Tuma, Irina ; Behling, Felix ; Schmidt-Graf, Friederike ; Meyer, Bernhard ; Gempt, Jens</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c524t-90d58ea3fa86f46bbca71b0157910bdfd0e353a7374a19cfede3bcd6f1a261cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biopsy</topic><topic>Brain cancer</topic><topic>Brain Neoplasms - surgery</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Data analysis</topic><topic>EOR</topic><topic>Female</topic><topic>Glioblastoma</topic><topic>Glioblastoma - surgery</topic><topic>Glioblastoma multiforme</topic><topic>Humans</topic><topic>Interdisciplinary aspects</topic><topic>Karnofsky Performance Status</topic><topic>Karnofsky performance status scale</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neurosurgery</topic><topic>Neurosurgical Procedures</topic><topic>Patients</topic><topic>Practice guidelines (Medicine)</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Survival analysis</topic><topic>Treatment Outcome</topic><topic>Tumor Burden</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barz, Melanie</creatorcontrib><creatorcontrib>Gerhardt, Julia</creatorcontrib><creatorcontrib>Bette, Stefanie</creatorcontrib><creatorcontrib>Aftahy, A Kaywan</creatorcontrib><creatorcontrib>Huber, Thomas</creatorcontrib><creatorcontrib>Combs, Stephanie E</creatorcontrib><creatorcontrib>Ryang, Yu-Mi</creatorcontrib><creatorcontrib>Wiestler, Benedikt</creatorcontrib><creatorcontrib>Skardelly, Marco</creatorcontrib><creatorcontrib>Gepfner-Tuma, Irina</creatorcontrib><creatorcontrib>Behling, Felix</creatorcontrib><creatorcontrib>Schmidt-Graf, Friederike</creatorcontrib><creatorcontrib>Meyer, Bernhard</creatorcontrib><creatorcontrib>Gempt, Jens</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barz, Melanie</au><au>Gerhardt, Julia</au><au>Bette, Stefanie</au><au>Aftahy, A Kaywan</au><au>Huber, Thomas</au><au>Combs, Stephanie E</au><au>Ryang, Yu-Mi</au><au>Wiestler, Benedikt</au><au>Skardelly, Marco</au><au>Gepfner-Tuma, Irina</au><au>Behling, Felix</au><au>Schmidt-Graf, Friederike</au><au>Meyer, Bernhard</au><au>Gempt, Jens</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale - a bicentric retrospective study</atitle><jtitle>BMC neurology</jtitle><addtitle>BMC Neurol</addtitle><date>2021-11-15</date><risdate>2021</risdate><volume>21</volume><issue>1</issue><spage>446</spage><epage>446</epage><pages>446-446</pages><artnum>446</artnum><issn>1471-2377</issn><eissn>1471-2377</eissn><abstract>Median overall survival (OS) after diagnosis of glioblastoma (GBM) remains 15 months amongst patients receiving aggressive surgical resection, chemotherapy and irradiation. Treatment of patients with a poor preoperative Karnofsky Performance Status Scale (KPSS) is still controversial. Therefore, we retrospectively assessed the outcome after surgical treatment in patients with a KPSS of ≤60%.
We retrospectively included patients with a de-novo glioblastoma WHO °IV and preoperative KPSS ≤60%, who underwent surgery at two neurosurgical centres between September 2006 and March 2016. We recorded pre- and postoperative tumour volume, pre- and postoperative KPSS, OS, age and MGMT promoter status.
One hundred twenty-three patients (58 females/65 males, mean age 67.4 ± 13.4 years) met the inclusion criteria. Seventy-five of the 123 patients (61%) underwent surgical resection. 48/123 patients (39%) received a biopsy. The median preoperative and postoperative tumour volume of all patients was 33.0 ± 31.3 cm
(IR 15.0-56.5cm
) and 3.1 ± 23.8 cm
(IR 0.2-15.0 cm
), respectively. The median KPSS was 60% (range 20-60%) preoperatively and 50% (range 0-80%) postoperatively. Patients who received a biopsy showed a median OS for patients who received a biopsy only was 3.0 months (95% CI 2.0-4.0 months), compared to patients who had a resection and had a median OS of 8 months (95% CI 3.1-12.9 months). Age (p < 0.001, HR: 1.045 [95% CI 1.022-1.068]), postoperative tumour volume (p = 0.02, HR: 1.016 [95% CI 1.002-1.029]) and MGMT promotor status (p = 0.016, HR: 0.473 [95% CI 0.257-0.871]) were statistically significant in multivariate analysis. In subgroup analyses only age was shown as a significant prognostic factor in multivariate analyses for patients receiving surgery (p < 0.001, HR: 1.046 [95% CI 1.022-1.072]). In the biopsy group no significant prognostic factors were shown in multivariate analysis.
GBM patients with a preoperative KPSS of ≤60% might profit from surgical reduction of tumour burden.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>34781889</pmid><doi>10.1186/s12883-021-02424-0</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-8734-9309</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC neurology, 2021-11, Vol.21 (1), p.446-446, Article 446 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access; Springer Nature OA Free Journals |
| subjects | Age Aged Aged, 80 and over Biopsy Brain cancer Brain Neoplasms - surgery Care and treatment Chemotherapy Data analysis EOR Female Glioblastoma Glioblastoma - surgery Glioblastoma multiforme Humans Interdisciplinary aspects Karnofsky Performance Status Karnofsky performance status scale Magnetic resonance imaging Male Medical prognosis Middle Aged Multivariate analysis Neurosurgery Neurosurgical Procedures Patients Practice guidelines (Medicine) Prognosis Retrospective Studies Statistical analysis Surgery Survival analysis Treatment Outcome Tumor Burden Tumors |
| title | Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale - a bicentric retrospective study |
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