Version 1
: Received: 25 September 2024 / Approved: 26 September 2024 / Online: 26 September 2024 (09:16:19 CEST)
How to cite:
Gonçalves, J. M.; Ferreira, F.; Carvalho, B.; Polónia, P.; Linhares, P. Survival Determinants in Glioblastoma: An Insight into Biopsy-Only Patient Outcomes. Preprints2024, 2024092062. https://doi.org/10.20944/preprints202409.2062.v1
Gonçalves, J. M.; Ferreira, F.; Carvalho, B.; Polónia, P.; Linhares, P. Survival Determinants in Glioblastoma: An Insight into Biopsy-Only Patient Outcomes. Preprints 2024, 2024092062. https://doi.org/10.20944/preprints202409.2062.v1
Gonçalves, J. M.; Ferreira, F.; Carvalho, B.; Polónia, P.; Linhares, P. Survival Determinants in Glioblastoma: An Insight into Biopsy-Only Patient Outcomes. Preprints2024, 2024092062. https://doi.org/10.20944/preprints202409.2062.v1
APA Style
Gonçalves, J. M., Ferreira, F., Carvalho, B., Polónia, P., & Linhares, P. (2024). Survival Determinants in Glioblastoma: An Insight into Biopsy-Only Patient Outcomes. Preprints. https://doi.org/10.20944/preprints202409.2062.v1
Chicago/Turabian Style
Gonçalves, J. M., Patrícia Polónia and Paulo Linhares. 2024 "Survival Determinants in Glioblastoma: An Insight into Biopsy-Only Patient Outcomes" Preprints. https://doi.org/10.20944/preprints202409.2062.v1
Abstract
Glioblastoma is a challenge in neuro-oncology, with survival significantly
influenced mainly by extent of resection and molecular markers. Despite
advancements, the prognosis for IDH-wildtype glioblastoma remains poor,
particularly when surgical resection is not possible. However, some patients
exhibit unexpectedly extended survival despite the extent of resection. This study aims to analyze the determinants that contribute to these atypical survival rates among glioblastoma patients who have had solely biopsy procedures.
We conducted a retrospective analysis of patients diagnosed with IDH-
wildtype glioblastomas at our institution from 2017 to 2021, who underwent
biopsy only. The study focused on evaluating the impact of demographic
characteristics, clinical features, molecular markers and treatment modalities on
survival outcomes (Overall Survival (OS) and Progression-Free Survival (PFS)).
Statistical analyses included survival analysis and logistic regression for
evaluating associations between OS and preoperative characteristics and
postoperative treatments.
The cohort included 99 patients, with a median age at diagnosis of 65.5
years. Median OS and PFS were 6.0 and 3.6 months, respectively. The
multivariate analysis revealed that higher KPS scores before biopsy, no contrast
uptake on imaging and any adjuvant therapy, particularly the use of
bevacizumab, were independently associated to increased OS (HR=0.97, p=0.009.
HR=0.7, p=0.015; HR=0.27, p=0.002, respectively). Out of 99 patients, 77.8%
survived past the 3-month threshold, with 87.0% of this receiving adjuvant
treatment. Only 8% of patients survived past 24 months, and in this group of patients, MGMT Methylation was observed in just 25% of cases. Kaplan-Meier analysis indicated a better prognosis with any type of adjuvant therapy across all patients, particularly so in those with KPS ≥70. Age did not significantly affect survival outcomes (OR=1.00, p=0.835).
Our findings reveal that any adjuvant treatment, no contrast uptake on imaging and higher preoperative KPS are key determinants of survival in IDH wildtype glioblastoma and should therefore be considered when deciding whether to perform a biopsy.
Medicine and Pharmacology, Oncology and Oncogenics
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
