title: Survival prognostic factors in patients with glioblastoma: our experience.
abstract: OBJECTIVE
  Approximate survival for glioblastoma is less than 1 year. Age, histological features and performance status at presentation represent the three statistically independent factors affecting longevity. The purpose of the study was to assess the role of surgery and to analyze prognostic factors in our patients operated for glioblastoma.
  
  
  METHODS
  We evaluated in 56 patients operated for glioblastoma their depressive and performance status in the preoperative and postoperative time. Moreover we analyzed the extent of surgery, the site and the size of lesions.
  
  
  RESULTS
  Median overall survival was 17 months. An age of ≥60 years (P<0.03), a preoperative Karnofsky Performance Status KPS≤70 (P=0.04), a subtotal tumor resection (P<0.001), a tumor size >5 cm (P=0.01), and no postoperative adjuvant treatment (P=0.01) were associated with the worst prognosis. Before surgery we found the presence of depression in 10 patients with a significative reduction of mean Back Depression Inventory scores after tumor resection (P=0.03). Finally, a KPS≤70 was significantly associated with an increased incidence of depression in the postoperative time.
  
  
  CONCLUSIONS
  Tumor size, total resection and affective disorders were identified as predictors of survival in our series of patients with glioblastoma in addition to age and KPS score. In our opinion an early diagnosis and the use of specific safeguards in the operating room contribute to have an extension of the tumor progression time and median survival.
authors.affiliation: Department of Health Sciences, University of L'Aquila, L'Aquila, Italy. soheila.raysi@alice.it
authors.forename: S
authors.initials: S
authors.lastname: Raysi Dehcordi
authors.forename: D
authors.initials: D
authors.lastname: De Paulis
authors.forename: S
authors.initials: S
authors.lastname: Marzi
authors.forename: A
authors.initials: A
authors.lastname: Ricci
authors.forename: A
authors.initials: A
authors.lastname: Cimini
authors.forename: M G
authors.initials: MG
authors.lastname: Cifone
authors.forename: R J
authors.initials: RJ
authors.lastname: Galzio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality* / Q000523:psychology / Q000601:surgery*; D003866:Depressive Disorder / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005909:Glioblastoma / Q000401:mortality* / Q000523:psychology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000523:psychology; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data