title: Factors associated with survival for patients with glioblastoma with poor pre-operative functional status.
abstract: Patients with glioblastoma (GB) are known to have poor prognoses, and among these patients, those with poor neurological function have an even poorer prognosis. Consequently, aggressive surgeries and adjuvant therapies are often withheld because of this dismal outlook. The effects of aggressive therapies in this small subset of patients remain unknown. The goal of this study was to evaluate outcomes and factors associated with survival for poor functioning patients who underwent aggressive resection of their GB. Adult patients who underwent surgical resection of an intracranial primary GB at an academic tertiary-care institution between 1997 and 2007 were retrospectively reviewed. Patients with a Karnofsky Performance Scale (KPS) score of ≤60 were included. A total of 100 patients with primary GB met the inclusion criteria. The average age (± standard deviation) and KPS score of this cohort were 54 ± 15 years and 53 ± 12, respectively. No patient (0%) experienced perioperative mortality, and 0 (0%), 10 (10%), and 3 (3%) of patients incurred a new or increasing language, motor, and visual deficit, respectively. At last follow-up, 88 (88%) patients died with a median survival of 6.6 months. The factors associated with improved survival were age <65 year (p = 0.005), tumor size >2 cm (p = 0.01), radical tumor resection (p=0.01), and temozolomide (p = 0.001). This study identifies a subset of patients with poor functional status who may benefit from aggressive surgical resection.
authors: Neuro-Oncology Outcomes Laboratory, Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21202, USA. Kaisorn@jhmi.edu
authors: Kaisorn L
authors: KL
authors: Chaichana
authors: Juan Carlos
authors: JC
authors: Martinez-Gutierrez
authors: Rafael
authors: R
authors: De la Garza-Ramos
authors: Jon D
authors: JD
authors: Weingart
authors: Alessandro
authors: A
authors: Olivi
authors: Gary L
authors: GL
authors: Gallia
authors: Michael
authors: M
authors: Lim
authors: Henry
authors: H
authors: Brem
authors: Alfredo
authors: A
authors: Quinones-Hinojosa
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016543:Central Nervous System Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D017567:Karnofsky Performance Status; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome
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