title: Primary human glioblastomas - prognostic value of clinical and histopathological parameters.
abstract: BACKGROUND
  Glioblastoma (GBM) is the most common primary malignant human brain tumor with a poor prognosis. The diagnosis of GBM is based on histological features, however, few studies have evaluated their prognostic relevance in light of the latest WHO classification of 2007.
  
  
  OBJECTIVE
  In this study we have evaluated the prognostic value of several clinical and histological characteristics encountered in human GBMs according to the WHO 2007 criteria.
  
  
  METHODS
  199 patients with primary GBM consecutively operated and histologically reviewed according to the 2007 WHO scheme, were included. Several clinical and histological features were recorded and related to survival.
  
  
  RESULTS
  Mean age of the GBM patients at diagnosis was 62 years (range 21 - 84). Male/female ratio was 1.3/1, and the median survival was 8.0 months (95% CI: 7.1 - 9.0 months). In a multivariate COX analysis age, WHO performance score, subcortical localization, extent of surgery, radiation treatment, chemotherapy, and the presence of large necrosis had individual effect on overall survival (p < 0.05). In addition, females, tumors with angiocentric growth, with pseudopalisades, or without lymphocyte infiltration were related to shorter survival in univariate analyses (p < 0.05).
  
  
  CONCLUSIONS
  Our findings confirm the strong prognostic value of age, treatment, performance score, and localization for glioblastoma patients. Amongst the histopathological features only large necrosis was an independent prognostic factor.
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology,Trondheim, Norway. andrehab@stud.ntnu.no
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Habberstad
authors.forename: Tove
authors.initials: T
authors.lastname: Lind-Landström
authors.forename: Stein
authors.initials: S
authors.lastname: Sundstrøm
authors.forename: Sverre H
authors.initials: SH
authors.lastname: Torp
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000145:classification* / Q000401:mortality* / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D005909:Glioblastoma / Q000145:classification* / Q000401:mortality* / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011379:Prognosis; D016016:Proportional Hazards Models; D011878:Radiotherapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014944:World Health Organization; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents