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Cerrahi Tedavi Uygulanan Glioblastomlu Hastalarda Prognostik Faktörler ve Peritümöral Ödemin Sağ Kalım Üzerine Etkisi

Year 2021, Volume: 5 Issue: 2, 226 - 231, 29.05.2021
https://doi.org/10.29058/mjwbs.867967

Abstract

Amaç: Cerrahi rezeksiyon sonrasında radyoterapi ve eş zamanlı kemoterapi uygulanan glioblastomlu hastaların genel özellikleri, sağ kalım süreleri, buna etki eden faktörleri ve peritümöral ödemin sağ kalıma etkisi geriye doğru incelenerek sonuçlar literatürle karşılaştırılmıştır.

Hastalar ve Yöntem: Bu çalışmada Mayıs 2014-Kasım 2020 tarihleri arasında cerrahi rezeksiyon uygulanan ve histopatolojik tanısı WHO klasifikasyonuna göre glioblastom olan 69 hasta dahil edilmiştir. Çalışmaya 18 yaş üzerinde, takip süresi 2 aydan uzun olan ve radyoterapi ile eş zamanlı temozolomid tedavisi uygulanan hastalar dahil edilmiştir. Bilateral özellik gösteren, beyin sapı, talamus, infratentorial yerleşimli kitlesi olan hastalar ve sadece biyopsi yapılan hastalar dahil edilmemiştir.

Bulgular: Yaş (p=0,015) ve rezeksiyon miktarının (p=0,044) glioblastomlu hastalarda prognostik faktör olduğu ortaya konmuştur. Tanı anındaki peritümöral beyin ödemi, cinsiyet, kitlenin yerleştiği taraf ve tümör boyutu prognostik faktör olarak bulunmamıştır.

Sonuç: Glioblastom tanılı hastalarda PBÖ, kitlenin total olarak çıkarılmasını zorlaştırmaktadır. Fakat, PBÖ’nün glioblastom tanılı hastalarda prognostik bir faktör olmadığı belirlenmiştir.

References

  • 1. Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011–2015. Neuro-oncology. 2018;20(suppl_4):iv1–86.
  • 2. Arvold ND, Reardon DA. Treatment options and outcomes for glioblastoma in the elderly patient. Clinical interventions in aging. 2014;9:357.
  • 3. Sanai N, Berger MS. Glioma extent of resection and its impact on patient outcome. Neurosurgery. 2008;62(4):753–66.
  • 4. Helseth R, Helseth E, Johannesen T, Langberg C, Lote K, Rønning P, et al. Overall survival, prognostic factors, and repeated surgery in a consecutive series of 516 patients with glioblastoma multiforme. Acta neurologica scandinavica. 2010;122(3):159–67.
  • 5. Ryken TC, Frankel B, Julien T, Olson JJ. Surgical management of newly diagnosed glioblastoma in adults: role of cytoreductive surgery. Journal of neuro-oncology. 2008;89(3):271.
  • 6. Stupp R, Mason WP, Van Den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. New England journal of medicine. 2005;352(10):987–96.
  • 7. Ohgaki H, Kleihues P. Epidemiology and etiology of gliomas. Acta neuropathologica. 2005;109(1):93–108.
  • 8. Buckner JC. Factors influencing survival in high-grade gliomas. In Elsevier; 2003. p. 10–4.
  • 9. Carson KA, Grossman SA, Fisher JD, Shaw EG. Prognostic Factors for Survival in Adult Patients with Recurrent Glioma Enrolled on New Approaches to Brain Tumor Therapy “NABTT” CNS Consortium Phase I and II Clinical Trials. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2007;25(18):2601.
  • 10. Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. Journal of neurosurgery. 2001;95(2):190–8.
  • 11. Stark AM, Nabavi A, Mehdorn HM, Blömer U. Glioblastoma multiforme—report of 267 cases treated at a single institution. Surgical neurology. 2005;63(2):162–9.
  • 12. Stummer W. Extent of Resection and Survival in Glioblastoma Multiforme. Neurosurgery. 2009;64(6):E1206.
  • 13. Gorlia T, van den Bent MJ, Hegi ME, Mirimanoff RO, Weller M, Cairncross JG, et al. Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981-22981/CE. 3. The lancet oncology. 2008;9(1):29–38.
  • 14. Hill C, Hunter SB, Brat DJ. Genetic Markers in Glioblastoma: Prognostic Significance and Future Therapeutic Implications: On: Impact of Genotype Morphology on the Prognosis of Glioblastoma. Schmidt MC Antweiler S, Urban N, et al. J Neuropathol Exp Neurol 2002; 61: 321–328. Advances in anatomic pathology. 2003;10(4):212–7.
  • 15. Shinojima N, Tada K, Shiraishi S, Kamiryo T, Kochi M, Nakamura H, et al. Prognostic value of epidermal growth factor receptor in patients with glioblastoma multiforme. Cancer research. 2003;63(20):6962–70.
  • 16. Schoenegger K, Oberndorfer S, Wuschitz B, Struhal W, Hainfellner J, Prayer D, et al. Peritumoral edema on MRI at initial diagnosis: an independent prognostic factor for glioblastoma? European journal of neurology. 2009;16(7):874–8.
  • 17. Stummer W. Mechanisms of tumor-related brain edema. Neurosurgical focus. 2007;22(5):1–7.
  • 18. Hammoud MA, Sawaya R, Shi W, Thall PF, Leeds NE. Prognostic significance of preoperative MRI scans in glioblastoma multiforme. Journal of neuro-oncology. 1996;27(1):65–73.
  • 19. Pope WB, Sayre J, Perlina A, Villablanca JP, Mischel PS, Cloughesy TF. MR imaging correlates of survival in patients with high-grade gliomas. American Journal of Neuroradiology. 2005;26(10):2466–74.
  • 20. Tortosa A, Viñolas N, Villà S, Verger E, Gil JM, Brell M, et al. Prognostic implication of clinical, radiologic, and pathologic features in patients with anaplastic gliomas. Cancer: Interdisciplinary International Journal of the American Cancer Society. 2003;97(4):1063–71.
  • 21. Xue D, Albright Jr RE. Preoperative anaplastic glioma tumor volume effects on patient survival. Journal of surgical oncology. 1999;72(4):199–205.
  • 22. Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen H-J, et al. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. The lancet oncology. 2006;7(5):392–401.
  • 23. Li YM, Suki D, Hess K, Sawaya R. The influence of maximum safe resection of glioblastoma on survival in 1229 patients: Can we do better than gross-total resection? J Neurosurg. 2016 Apr;124(4):977–88.
  • 24. Han SJ, Sughrue ME. The rise and fall of “biopsy and radiate”: a history of surgical nihilism in glioma treatment. Neurosurg Clin N Am. 2012 Apr;23(2):207–14, vii.
  • 25. Rahman M, Abbatematteo J, De Leo EK, Kubilis PS, Vaziri S, Bova F, et al. The effects of new or worsened postoperative neurological deficits on survival of patients with glioblastoma. J Neurosurg. 2017 Jul;127(1):123–31.
  • 26. Zhou X, Niu X, Mao Q, Liu Y. Clinical Significance of Various Classification Standards of Age Groups in Predicting Survival of Patients with Glioblastoma. Med Sci Monit. 2020 May 30;26:e920627.
  • 27. Gately L, Collins A, Murphy M, Dowling A. Age alone is not a predictor for survival in glioblastoma. Journal of neuro-oncology. 2016;129(3):479–85.
  • 28. Mazurowski MA, Zhang J, Peters KB, Hobbs H. Computer-extracted MR imaging features are associated with survival in glioblastoma patients. Journal of neuro-oncology. 2014;120(3):483–8.
  • 29. Gutman DA, Cooper LA, Hwang SN, Holder CA, Gao J, Aurora TD, et al. MR imaging predictors of molecular profile and survival: multi-institutional study of the TCGA glioblastoma data set. Radiology. 2013;267(2):560–9.
  • 30. Marcus HJ, Williams S, Hughes-Hallett A, Camp SJ, Nandi D, Thorne L. Predicting surgical outcome in patients with glioblastoma multiforme using pre-operative magnetic resonance imaging: development and preliminary validation of a grading system. Neurosurgical Review. 2017;40(4):621–31.

Prognostic Factors and Effect of Peritumoral Edema on Survival in Patients with Glioblastoma underwent Resection.

Year 2021, Volume: 5 Issue: 2, 226 - 231, 29.05.2021
https://doi.org/10.29058/mjwbs.867967

Abstract

Objective: The general characteristics, survival periods, factors affecting survival and the effect of peritumoral brain edema on survival of patients with glioblastoma treated with radiotherapy and concurrent chemotherapy after surgical resection were examined retrospectively and the results were compared with the literature.

Patients and Methods: In this study, 69 patients who underwent surgical resection between May 2014 and November 2020 and whose histopathological diagnosis was glioblastoma according to the WHO classification were included. Patients over 18 years of age, with a follow-up period of more than 2 months and treated with radiotherapy simultaneously with temozolomide were included in the study. Patients with bilateral, brainstem, thalamus, infratentorial involvement and patients who only had biopsy were not included.

Results: Age (p = 0.015) and amount of resection (p = 0.044) were found to be prognostic factors in patients with glioblastoma. Peritumoral brain edema at the time of diagnosis, gender, site of the mass and tumor size were not found as prognostic factors.

Conclusion: Peritumoral edema makes total removal of the mass difficult in patients with a diagnosis of glioblastoma. However, it has been determined that peritumoral edema is not a prognostic factor.

References

  • 1. Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011–2015. Neuro-oncology. 2018;20(suppl_4):iv1–86.
  • 2. Arvold ND, Reardon DA. Treatment options and outcomes for glioblastoma in the elderly patient. Clinical interventions in aging. 2014;9:357.
  • 3. Sanai N, Berger MS. Glioma extent of resection and its impact on patient outcome. Neurosurgery. 2008;62(4):753–66.
  • 4. Helseth R, Helseth E, Johannesen T, Langberg C, Lote K, Rønning P, et al. Overall survival, prognostic factors, and repeated surgery in a consecutive series of 516 patients with glioblastoma multiforme. Acta neurologica scandinavica. 2010;122(3):159–67.
  • 5. Ryken TC, Frankel B, Julien T, Olson JJ. Surgical management of newly diagnosed glioblastoma in adults: role of cytoreductive surgery. Journal of neuro-oncology. 2008;89(3):271.
  • 6. Stupp R, Mason WP, Van Den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. New England journal of medicine. 2005;352(10):987–96.
  • 7. Ohgaki H, Kleihues P. Epidemiology and etiology of gliomas. Acta neuropathologica. 2005;109(1):93–108.
  • 8. Buckner JC. Factors influencing survival in high-grade gliomas. In Elsevier; 2003. p. 10–4.
  • 9. Carson KA, Grossman SA, Fisher JD, Shaw EG. Prognostic Factors for Survival in Adult Patients with Recurrent Glioma Enrolled on New Approaches to Brain Tumor Therapy “NABTT” CNS Consortium Phase I and II Clinical Trials. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2007;25(18):2601.
  • 10. Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. Journal of neurosurgery. 2001;95(2):190–8.
  • 11. Stark AM, Nabavi A, Mehdorn HM, Blömer U. Glioblastoma multiforme—report of 267 cases treated at a single institution. Surgical neurology. 2005;63(2):162–9.
  • 12. Stummer W. Extent of Resection and Survival in Glioblastoma Multiforme. Neurosurgery. 2009;64(6):E1206.
  • 13. Gorlia T, van den Bent MJ, Hegi ME, Mirimanoff RO, Weller M, Cairncross JG, et al. Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981-22981/CE. 3. The lancet oncology. 2008;9(1):29–38.
  • 14. Hill C, Hunter SB, Brat DJ. Genetic Markers in Glioblastoma: Prognostic Significance and Future Therapeutic Implications: On: Impact of Genotype Morphology on the Prognosis of Glioblastoma. Schmidt MC Antweiler S, Urban N, et al. J Neuropathol Exp Neurol 2002; 61: 321–328. Advances in anatomic pathology. 2003;10(4):212–7.
  • 15. Shinojima N, Tada K, Shiraishi S, Kamiryo T, Kochi M, Nakamura H, et al. Prognostic value of epidermal growth factor receptor in patients with glioblastoma multiforme. Cancer research. 2003;63(20):6962–70.
  • 16. Schoenegger K, Oberndorfer S, Wuschitz B, Struhal W, Hainfellner J, Prayer D, et al. Peritumoral edema on MRI at initial diagnosis: an independent prognostic factor for glioblastoma? European journal of neurology. 2009;16(7):874–8.
  • 17. Stummer W. Mechanisms of tumor-related brain edema. Neurosurgical focus. 2007;22(5):1–7.
  • 18. Hammoud MA, Sawaya R, Shi W, Thall PF, Leeds NE. Prognostic significance of preoperative MRI scans in glioblastoma multiforme. Journal of neuro-oncology. 1996;27(1):65–73.
  • 19. Pope WB, Sayre J, Perlina A, Villablanca JP, Mischel PS, Cloughesy TF. MR imaging correlates of survival in patients with high-grade gliomas. American Journal of Neuroradiology. 2005;26(10):2466–74.
  • 20. Tortosa A, Viñolas N, Villà S, Verger E, Gil JM, Brell M, et al. Prognostic implication of clinical, radiologic, and pathologic features in patients with anaplastic gliomas. Cancer: Interdisciplinary International Journal of the American Cancer Society. 2003;97(4):1063–71.
  • 21. Xue D, Albright Jr RE. Preoperative anaplastic glioma tumor volume effects on patient survival. Journal of surgical oncology. 1999;72(4):199–205.
  • 22. Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen H-J, et al. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. The lancet oncology. 2006;7(5):392–401.
  • 23. Li YM, Suki D, Hess K, Sawaya R. The influence of maximum safe resection of glioblastoma on survival in 1229 patients: Can we do better than gross-total resection? J Neurosurg. 2016 Apr;124(4):977–88.
  • 24. Han SJ, Sughrue ME. The rise and fall of “biopsy and radiate”: a history of surgical nihilism in glioma treatment. Neurosurg Clin N Am. 2012 Apr;23(2):207–14, vii.
  • 25. Rahman M, Abbatematteo J, De Leo EK, Kubilis PS, Vaziri S, Bova F, et al. The effects of new or worsened postoperative neurological deficits on survival of patients with glioblastoma. J Neurosurg. 2017 Jul;127(1):123–31.
  • 26. Zhou X, Niu X, Mao Q, Liu Y. Clinical Significance of Various Classification Standards of Age Groups in Predicting Survival of Patients with Glioblastoma. Med Sci Monit. 2020 May 30;26:e920627.
  • 27. Gately L, Collins A, Murphy M, Dowling A. Age alone is not a predictor for survival in glioblastoma. Journal of neuro-oncology. 2016;129(3):479–85.
  • 28. Mazurowski MA, Zhang J, Peters KB, Hobbs H. Computer-extracted MR imaging features are associated with survival in glioblastoma patients. Journal of neuro-oncology. 2014;120(3):483–8.
  • 29. Gutman DA, Cooper LA, Hwang SN, Holder CA, Gao J, Aurora TD, et al. MR imaging predictors of molecular profile and survival: multi-institutional study of the TCGA glioblastoma data set. Radiology. 2013;267(2):560–9.
  • 30. Marcus HJ, Williams S, Hughes-Hallett A, Camp SJ, Nandi D, Thorne L. Predicting surgical outcome in patients with glioblastoma multiforme using pre-operative magnetic resonance imaging: development and preliminary validation of a grading system. Neurosurgical Review. 2017;40(4):621–31.
There are 30 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Article
Authors

Alican Tahta 0000-0003-0467-7521

Publication Date May 29, 2021
Acceptance Date March 1, 2021
Published in Issue Year 2021 Volume: 5 Issue: 2

Cite

Vancouver Tahta A. Cerrahi Tedavi Uygulanan Glioblastomlu Hastalarda Prognostik Faktörler ve Peritümöral Ödemin Sağ Kalım Üzerine Etkisi. Med J West Black Sea. 2021;5(2):226-31.

Medical Journal of Western Black Sea is a scientific publication of Zonguldak Bulent Ecevit University Faculty of Medicine.

This is a refereed journal, which aims at achieving free knowledge to the national and international organizations and individuals related to medical sciences in publishedand electronic forms.

This journal is published three annually in April, August and December.
The publication language of the journal is Turkish and English.