A Simple Preoperative Blood Count to Stratify Prognosis in Isocitrate Dehydrogenase-Wildtype Glioblastoma Patients Treated with Radiotherapy plus Concomitant and Adjuvant Temozolomide
Purpose: The survival times of glioblastoma (GB) patients after the standard therapy including safe maximal resection followed by radiotherapy plus concomitant and adjuvant temozolomide are heterogeneous. In order to define a simple, reliable method for predicting whether patients with isocitrate de...
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2021
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oai:doaj.org-article:7f0c23537c00436eb01fbe8635bfe1952021-11-25T17:03:55ZA Simple Preoperative Blood Count to Stratify Prognosis in Isocitrate Dehydrogenase-Wildtype Glioblastoma Patients Treated with Radiotherapy plus Concomitant and Adjuvant Temozolomide10.3390/cancers132257782072-6694https://doaj.org/article/7f0c23537c00436eb01fbe8635bfe1952021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5778https://doaj.org/toc/2072-6694Purpose: The survival times of glioblastoma (GB) patients after the standard therapy including safe maximal resection followed by radiotherapy plus concomitant and adjuvant temozolomide are heterogeneous. In order to define a simple, reliable method for predicting whether patients with isocitrate dehydrogenase (IDH)-wildtype GB treated with the standard therapy will be short- or long-term survivors, we analyzed the correlation of preoperative blood counts and their combined forms with progression-free survival (PFS) and overall survival (OS) in these patients. Methods: Eighty-five patients with primary IDH-wildtype GB treated with the standard therapy between 2012 and 2019 were analyzed retrospectively. Cox proportional hazards models and Kaplan–Meier analysis were used to investigate the survival function of preoperative hematological parameters. Results: Preoperative high neutrophil-to-lymphocyte ratio (NLR, >2.42), high platelet count (>236 × 10<sup>9</sup>/L), and low red blood cell (RBC) count (≤4.59 × 10<sup>12</sup>/L) were independent prognostic factors for poorer OS (<i>p</i> = 0.030, <i>p</i> = 0.030, and <i>p</i> = 0.004, respectively). Moreover, a high NLR was an independent prognostic factor for shorter PFS (<i>p</i> = 0.010). We also found that, like NLR, preoperative high derived NLR (dNLR, >1.89) was of poor prognostic value for both PFS (<i>p</i> = 0.002) and OS (<i>p</i> = 0.033). A significant correlation was observed between NLR and dNLR (r = 0.88, <i>p</i> < 0.001), which had a similar prognostic power for OS (NLR: AUC = 0.58; 95% CI: [0.48; 0.68]; dNLR: AUC = 0.62; 95% CI: [0.51; 0.72]). Two scores, one based on preoperative platelet and RBC counts plus NLR and the other on preoperative platelet and RBC counts plus dNLR, were found to be independent prognostic factors for PFS (<i>p</i> = 0.006 and <i>p</i> = 0.002, respectively) and OS (<i>p</i> < 0.001 for both scores). Conclusion: Cheap, routinely ordered, preoperative assessments of blood markers, such as NLR, dNLR, RBC, and platelet counts, can predict the survival outcomes of patients with IDH-wildtype GB treated with the standard therapy.Anne ClavreulJean-Michel LeméeGwénaëlle SoulardAudrey RousseauPhilippe MeneiMDPI AGarticleglioblastomahematological markerssurvivalprognosisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5778, p 5778 (2021) |
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glioblastoma hematological markers survival prognosis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
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glioblastoma hematological markers survival prognosis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Anne Clavreul Jean-Michel Lemée Gwénaëlle Soulard Audrey Rousseau Philippe Menei A Simple Preoperative Blood Count to Stratify Prognosis in Isocitrate Dehydrogenase-Wildtype Glioblastoma Patients Treated with Radiotherapy plus Concomitant and Adjuvant Temozolomide |
| description |
Purpose: The survival times of glioblastoma (GB) patients after the standard therapy including safe maximal resection followed by radiotherapy plus concomitant and adjuvant temozolomide are heterogeneous. In order to define a simple, reliable method for predicting whether patients with isocitrate dehydrogenase (IDH)-wildtype GB treated with the standard therapy will be short- or long-term survivors, we analyzed the correlation of preoperative blood counts and their combined forms with progression-free survival (PFS) and overall survival (OS) in these patients. Methods: Eighty-five patients with primary IDH-wildtype GB treated with the standard therapy between 2012 and 2019 were analyzed retrospectively. Cox proportional hazards models and Kaplan–Meier analysis were used to investigate the survival function of preoperative hematological parameters. Results: Preoperative high neutrophil-to-lymphocyte ratio (NLR, >2.42), high platelet count (>236 × 10<sup>9</sup>/L), and low red blood cell (RBC) count (≤4.59 × 10<sup>12</sup>/L) were independent prognostic factors for poorer OS (<i>p</i> = 0.030, <i>p</i> = 0.030, and <i>p</i> = 0.004, respectively). Moreover, a high NLR was an independent prognostic factor for shorter PFS (<i>p</i> = 0.010). We also found that, like NLR, preoperative high derived NLR (dNLR, >1.89) was of poor prognostic value for both PFS (<i>p</i> = 0.002) and OS (<i>p</i> = 0.033). A significant correlation was observed between NLR and dNLR (r = 0.88, <i>p</i> < 0.001), which had a similar prognostic power for OS (NLR: AUC = 0.58; 95% CI: [0.48; 0.68]; dNLR: AUC = 0.62; 95% CI: [0.51; 0.72]). Two scores, one based on preoperative platelet and RBC counts plus NLR and the other on preoperative platelet and RBC counts plus dNLR, were found to be independent prognostic factors for PFS (<i>p</i> = 0.006 and <i>p</i> = 0.002, respectively) and OS (<i>p</i> < 0.001 for both scores). Conclusion: Cheap, routinely ordered, preoperative assessments of blood markers, such as NLR, dNLR, RBC, and platelet counts, can predict the survival outcomes of patients with IDH-wildtype GB treated with the standard therapy. |
| format |
article |
| author |
Anne Clavreul Jean-Michel Lemée Gwénaëlle Soulard Audrey Rousseau Philippe Menei |
| author_facet |
Anne Clavreul Jean-Michel Lemée Gwénaëlle Soulard Audrey Rousseau Philippe Menei |
| author_sort |
Anne Clavreul |
| title |
A Simple Preoperative Blood Count to Stratify Prognosis in Isocitrate Dehydrogenase-Wildtype Glioblastoma Patients Treated with Radiotherapy plus Concomitant and Adjuvant Temozolomide |
| title_short |
A Simple Preoperative Blood Count to Stratify Prognosis in Isocitrate Dehydrogenase-Wildtype Glioblastoma Patients Treated with Radiotherapy plus Concomitant and Adjuvant Temozolomide |
| title_full |
A Simple Preoperative Blood Count to Stratify Prognosis in Isocitrate Dehydrogenase-Wildtype Glioblastoma Patients Treated with Radiotherapy plus Concomitant and Adjuvant Temozolomide |
| title_fullStr |
A Simple Preoperative Blood Count to Stratify Prognosis in Isocitrate Dehydrogenase-Wildtype Glioblastoma Patients Treated with Radiotherapy plus Concomitant and Adjuvant Temozolomide |
| title_full_unstemmed |
A Simple Preoperative Blood Count to Stratify Prognosis in Isocitrate Dehydrogenase-Wildtype Glioblastoma Patients Treated with Radiotherapy plus Concomitant and Adjuvant Temozolomide |
| title_sort |
simple preoperative blood count to stratify prognosis in isocitrate dehydrogenase-wildtype glioblastoma patients treated with radiotherapy plus concomitant and adjuvant temozolomide |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/7f0c23537c00436eb01fbe8635bfe195 |
| work_keys_str_mv |
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| _version_ |
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