Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale – a bicentric retrospective study

Abstract Backround 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 controvers...

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Autores principales:	Melanie Barz, Julia Gerhardt, Stefanie Bette, A. Kaywan Aftahy, Thomas Huber, Stephanie E. Combs, Yu-Mi Ryang, Benedikt Wiestler, Marco Skardelly, Irina Gepfner-Tuma, Felix Behling, Friederike Schmidt-Graf, Bernhard Meyer, Jens Gempt
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Karnofsky performance status scale Glioblastoma Surgery EOR Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/7d1208e152054500bffd69bdaf272ce7
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spelling	oai:doaj.org-article:7d1208e152054500bffd69bdaf272ce72021-11-21T12:09:23ZPrognostic value of tumour volume in patients with a poor Karnofsky performance status scale – a bicentric retrospective study10.1186/s12883-021-02424-01471-2377https://doaj.org/article/7d1208e152054500bffd69bdaf272ce72021-11-01T00:00:00Zhttps://doi.org/10.1186/s12883-021-02424-0https://doaj.org/toc/1471-2377Abstract Backround 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%. Methods 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. Results 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 cm3 (IR 15.0–56.5cm3) and 3.1 ± 23.8 cm3 (IR 0.2–15.0 cm3), 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. Conclusion GBM patients with a preoperative KPSS of ≤60% might profit from surgical reduction of tumour burden.Melanie BarzJulia GerhardtStefanie BetteA. Kaywan AftahyThomas HuberStephanie E. CombsYu-Mi RyangBenedikt WiestlerMarco SkardellyIrina Gepfner-TumaFelix BehlingFriederike Schmidt-GrafBernhard MeyerJens GemptBMCarticleKarnofsky performance status scaleGlioblastomaSurgeryEORNeurology. Diseases of the nervous systemRC346-429ENBMC Neurology, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Karnofsky performance status scale Glioblastoma Surgery EOR Neurology. Diseases of the nervous system RC346-429
spellingShingle	Karnofsky performance status scale Glioblastoma Surgery EOR Neurology. Diseases of the nervous system RC346-429 Melanie Barz Julia Gerhardt Stefanie Bette A. Kaywan Aftahy Thomas Huber Stephanie E. Combs Yu-Mi Ryang Benedikt Wiestler Marco Skardelly Irina Gepfner-Tuma Felix Behling Friederike Schmidt-Graf Bernhard Meyer Jens Gempt Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale – a bicentric retrospective study
description	Abstract Backround 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%. Methods 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. Results 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 cm3 (IR 15.0–56.5cm3) and 3.1 ± 23.8 cm3 (IR 0.2–15.0 cm3), 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. Conclusion GBM patients with a preoperative KPSS of ≤60% might profit from surgical reduction of tumour burden.
format	article
author	Melanie Barz Julia Gerhardt Stefanie Bette A. Kaywan Aftahy Thomas Huber Stephanie E. Combs Yu-Mi Ryang Benedikt Wiestler Marco Skardelly Irina Gepfner-Tuma Felix Behling Friederike Schmidt-Graf Bernhard Meyer Jens Gempt
author_facet	Melanie Barz Julia Gerhardt Stefanie Bette A. Kaywan Aftahy Thomas Huber Stephanie E. Combs Yu-Mi Ryang Benedikt Wiestler Marco Skardelly Irina Gepfner-Tuma Felix Behling Friederike Schmidt-Graf Bernhard Meyer Jens Gempt
author_sort	Melanie Barz
title	Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale – a bicentric retrospective study
title_short	Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale – a bicentric retrospective study
title_full	Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale – a bicentric retrospective study
title_fullStr	Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale – a bicentric retrospective study
title_full_unstemmed	Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale – a bicentric retrospective study
title_sort	prognostic value of tumour volume in patients with a poor karnofsky performance status scale – a bicentric retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7d1208e152054500bffd69bdaf272ce7
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Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale – a bicentric retrospective study

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