Influence of T2 FLAIR Abnormalities in Survival Outcomes After Gross Total Resection of IDH Wildtype Glioblastomas. (16th November 2020)

• Record Type: Journal Article
• Authors: Domingo, Ricardo; Vivas-Buitrago, Tito; Tripathi, Shashwat; Brown, Desmond A; De Biase, Gaetano; Ramos-Fresnedo, Andres; Chaichana, Kaisorn L; Quinones-Hinojosa, Alfredo
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_899
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Survival benefits of supratotal resection for lower grade gliomas have been previously reported. However, little is known of the influence of supratotal resection in survival of patients with GBM who had GTR based on the T1 post-contrast enhancement. METHODS: Electronic records of 888 adult patients that underwent resection of newly diagnosed IDH-wildtype glioblastoma at our institution from January 2011 to December 2017 were reviewed. For every subject, preoperative and postoperative MRIs were evaluated. Relationship of the tumor to the lateral ventricles (LV) was classified. Image volumes were obtained by manually defining the region of interest (ROI). OS was plotted using Kaplan-Meier method ad log-rank analysis was used to analyze difference in Kaplan-Meier curves. Univariate and multivariate Cox proportional hazard models were recruited to analyze association between variables and OS. RESULTS: After appropriate inclusion criteria, 111 patients with a new diagnosis of GBM who underwent GTR at our institutions were included. In the multi-variate analysis, age > 65y (HR 1.97; P < .001), contact with lateral ventricles (HR 1.59; P = .025), were associated with shorter OS. Additionally, KPS > 70 (HR 0.47; P = .006) and MGMT promotor methylation (HR 0.63; P = .044) were associated with longer OS. Finally, T2/FLAIR EOR of 70% was found as the maximum threshold for association with favorable OS (HR 0.65; P = .031). CONCLUSION: In our cohort, age <65, KPS >70, MGMT methylated, and no contact with the LV were associated with beneficial OS. 70% EOR of the T2/FLAIR signal abnormality was found as the maximum threshold associated with favorable OS.