TY - JOUR
T1 - Factors associated with survival for patients with glioblastoma with poor pre-operative functional status
AU - Chaichana, Kaisorn L.
AU - Martinez-Gutierrez, Juan Carlos
AU - De La Garza-Ramos, Rafael
AU - Weingart, Jon D.
AU - Olivi, Alessandro
AU - Gallia, Gary L.
AU - Lim, Michael
AU - Brem, Henry
AU - Quinones-Hinojosa, Alfredo
PY - 2013/6
Y1 - 2013/6
N2 - Patients with glioblastoma (GB) are known to have poor prognoses, and among these patients, those with poor neurological function have an even poorer prognosis. Consequently, aggressive surgeries and adjuvant therapies are often withheld because of this dismal outlook. The effects of aggressive therapies in this small subset of patients remain unknown. The goal of this study was to evaluate outcomes and factors associated with survival for poor functioning patients who underwent aggressive resection of their GB. Adult patients who underwent surgical resection of an intracranial primary GB at an academic tertiary-care institution between 1997 and 2007 were retrospectively reviewed. Patients with a Karnofsky Performance Scale (KPS) score of ≤60 were included. A total of 100 patients with primary GB met the inclusion criteria. The average age (±standard deviation) and KPS score of this cohort were 54 ± 15 years and 53 ± 12, respectively. No patient (0%) experienced perioperative mortality, and 0 (0%), 10(10%), and 3 (3%) of patients incurred a new or increasing language, motor, and visual deficit, respectively. At last follow-up, 88 (88%) patients died with a median survival of 6.6 months. The factors associated with improved survival were age <65 year (p = 0.005), tumor size >2 cm (p = 0.01), radical tumor resection (p = 0.01), and temozolomide (p = 0.001). This study identifies a subset of patients with poor functional status who may benefit from aggressive surgical resection.
AB - Patients with glioblastoma (GB) are known to have poor prognoses, and among these patients, those with poor neurological function have an even poorer prognosis. Consequently, aggressive surgeries and adjuvant therapies are often withheld because of this dismal outlook. The effects of aggressive therapies in this small subset of patients remain unknown. The goal of this study was to evaluate outcomes and factors associated with survival for poor functioning patients who underwent aggressive resection of their GB. Adult patients who underwent surgical resection of an intracranial primary GB at an academic tertiary-care institution between 1997 and 2007 were retrospectively reviewed. Patients with a Karnofsky Performance Scale (KPS) score of ≤60 were included. A total of 100 patients with primary GB met the inclusion criteria. The average age (±standard deviation) and KPS score of this cohort were 54 ± 15 years and 53 ± 12, respectively. No patient (0%) experienced perioperative mortality, and 0 (0%), 10(10%), and 3 (3%) of patients incurred a new or increasing language, motor, and visual deficit, respectively. At last follow-up, 88 (88%) patients died with a median survival of 6.6 months. The factors associated with improved survival were age <65 year (p = 0.005), tumor size >2 cm (p = 0.01), radical tumor resection (p = 0.01), and temozolomide (p = 0.001). This study identifies a subset of patients with poor functional status who may benefit from aggressive surgical resection.
KW - Glioblastoma
KW - Karnofsky performance scale score
KW - Outcomes
KW - Poor neurological status
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=84891866212&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84891866212&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2012.07.016
DO - 10.1016/j.jocn.2012.07.016
M3 - Article
C2 - 23639620
AN - SCOPUS:84891866212
SN - 0967-5868
VL - 20
SP - 818
EP - 823
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
IS - 6
ER -