The influence of sex and the presence of giant cells on postoperative long-term survival in adult patients with supratentorial glioblastoma multiforme.
OBJECTIVE
Glioblastoma multiforme (GBM) remains incurable by conventional treatments, although some patients experience long-term survival. A younger age, a higher Karnofsky Performance Scale (KPS) score, more aggressive treatment, and long progression-free intervals have been reported to be positively associated with long-term postoperative patient survival. The aim of this retrospective study was the identification of additional favorable prognostic factors affecting long-term survival in surgically treated adult patients with supratentorial GBM.


METHODS
Of 113 adult patients newly diagnosed with histologically verified supratentorial GBM who were enrolled in Phase III trials during the period between 1987 and 1998, six (5.3%) who survived for longer than 5 years were defined as long-term survivors, whereas the remaining 107 patients served as controls. All six were women and were compared with the controls; they were younger (mean age 44.2 years, range 31-60 years), and their preoperative KPS scores were higher (mean 85, range 60-100). Four of the six patients underwent gross-total resection. In five patients (83.3%) the progression-free interval was longer than 5 years and in three a histopathological diagnosis of giant cell GBM was made. This diagnosis was not made in the other 107 patients.


CONCLUSIONS
Among adult patients with supratentorial GBM, female sex and histopathological characteristics consistent with giant cell GBM may be predictive of a better survival rate, as may traditional factors (that is, younger age, good KPS score, more aggressive resection, and a long progression-free interval).
Department of Neurosurgery, Kumamoto University School of Medicine, Kumamoto, Japan. shinojima@rio.odn.ne.jp
Naoki
N
Shinojima
Masato
M
Kochi
Jun-ichiro
J
Hamada
Hideo
H
Nakamura
Shigetoshi
S
Yano
Keishi
K
Makino
Hiromasa
H
Tsuiki
Kenji
K
Tada
Jun-ichi
J
Kuratsu
Yasuji
Y
Ishimaru
Yukitaka
Y
Ushio
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015726:Giant Cells; D005909:Glioblastoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D015173:Supratentorial Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data; D013997:Time Factors