Original Article
Factor analysis of cerebrospinal fluid spread in glioblastoma
Jian Huang, Mingxiao Li, Meiling Ma, Xiaohui Ren, Yong Cui, Song Lin
Published 2020-06-01
Cite as Chin J Surg, 2020, 58(6): 469-474. DOI: 10.3760/cma.j.cn112139-20191209-00599
Abstract
ObjectiveTo analyze the prognosis factors of cerebrospinal fluid (CSF) spread after surgery in glioblastoma (GBM) patients when tumors progressed and the effect factors on prognosis.
MethodsA retrospective study was conducted on 124 patients who were pathologically diagnosed as glioblastoma after surgery, and found tumor progressed during regularly follow-up at Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University between January 2009 and August 2017.There were 82 males and 42 females, aged 47.9 years(range: 19 to 75 years) .Patients were divided into local recurrence group(96 cases) and CSF spread group (28 cases) .Clinical data were recorded in detail and compared by independent sample t test or χ2 test.Kaplan-Meier survival curves was used to demonstrated the distribution of progression free survival (PFS) overall survival (OS) and post progression survival (PPS), and differences between local recurrence and CSF spread groups were assessed by Log-rank test.Cox proportion hazard regression analysis was used to identify independent prognostic factors.
ResultsLogistics regression analysis showed ventricle entry was the only prognosis factor of CSF spread (OR=2.667, 95% CI: 1.128 to 6.304, P=0.025).No significant distinction was observed in PFS between CSF spread group and local recurrence group(7.0 months vs.9.3 months, P=0.066).However, OS and PPS were substantially shortened in CSF spread group (13.0 months vs.23.0 months, P=0.011; 6.0 months vs.11.0 months, P=0.022, respectively).Mutations of isocitrate dehydrogenase gene, distant spread, gross-total resection, Ki-67 index>30% were independent prognostic factors of GBM patients.
ConclusionsVentricle entry is a prognosis factor for CSF spread, after which the median OS and PPS are markedly diminished.However, ventricle entry is not independent prognosis factor shortening survival.
Key words:
Glioblastoma; Factor analysis, statistical; Survival; Ventricle entry; Cerebrospinal fluid spread; Surgery
Contributor Information
Jian Huang
Department of Neurosurgery, Linyi Central Hospital, Linyi 276000, Shandong Province, China
Mingxiao Li
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Meiling Ma
Department of Neurology, Linyi Central Hospital, Linyi 276000, Shandong Province, China
Xiaohui Ren
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Yong Cui
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Song Lin
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China