Multi-institutional validation of a preoperative scoring system which predicts survival for patients with glioblastoma.
Multi-institutional validation of a preoperative scoring system which predicts survival for patients with glioblastoma.
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DOI：
10.1016/j.jocn.2013.02.007
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发表时间：
2013-10
影响因子：
2
通讯作者：
Quinones-Hinojos, Alfredo
中科院分区：
文献类型：
--
作者：
Chaichana, Kaisorn L.;Pendleton, Courtney;Chambless, Lola;Camara-Quintana, Joaquin;Nathan, Jay K.;Hassam-Malani, Laila;Li, Gordon;Harsh, Griffith R.;Thompson, Reid C.;Lim, Michael;Quinones-Hinojos, Alfredo
胶质母细胞瘤是成人中最常见和最具侵袭性的原发性脑肿瘤。平均生存期约为1年，但个体生存期是异质的。利用单一的机构经验，我们以前确定了与生存相关的术前因素，并根据这些因素设计了一个预后评分系统。本研究的目的是验证这些术前因素，并使用多机构队列验证该评分系统的有效性。在来自三个不同机构的334例患者中，考克斯分析发现与生存率负相关的术前因素为年龄>60岁（p < 0.0001），Karnofsky体能量表评分≤80（p = 0.03）、运动缺陷（p = 0.02）、语言缺陷（p = 0.04）和心室周围肿瘤位置（p = 0.04）。具有0-1、2、3和4-5个这些变量的患者分别被指定为术前等级1、2、3和4。术前分级为1、2、3和4级的患者的中位生存期分别为17.9、12.3、10和7.5个月。在对数秩分析中，这些等级中的每一个的存活率是统计学显著的（p < 0.05）。该分级系统仅基于术前变量，可以为患者和医生提供预后信息，这些信息可以在进行任何干预之前指导内科和外科治疗。
Glioblastoma is the most common and aggressive type of primary brain tumor in adults. Average survival is approximately 1 year, but individual survival is heterogeneous. Using a single institutional experience, we have previously identified preoperative factors associated with survival and devised a prognostic scoring system based on these factors. The aims of the present study are to validate these preoperative factors and verify the efficacy of this scoring system using a multi-institutional cohort. Of the 334 patients in this study from three different institutions, the preoperative factors found to be negatively associated with survival in a Cox analysis were age >60 years (p < 0.0001), Karnofsky Performance Scale score ≤80 (p = 0.03), motor deficit (p = 0.02), language deficit (p = 0.04), and periventricular tumor location (p = 0.04). Patients possessing 0–1, 2, 3, and 4–5 of these variables were assigned a preoperative grade of 1, 2, 3, and 4, respectively. Patients with a preoperative grade of 1, 2, 3, and 4 had a median survival of 17.9, 12.3,10, and 7.5 months, respectively. Survival of each of these grades was statistically significant (p < 0.05) in log-rank analysis. This grading system, based only on preoperative variables, may provide patients and physicians with prognostic information that may guide medical and surgical therapy before any intervention is pursued.
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