A Novel Comprehensive Clinical Stratification Model to Refine Prognosis of Glioblastoma Patients Undergoing Surgical Resection
Open Access
- 6 February 2020
- Vol. 12 (2), 386
- https://doi.org/10.3390/cancers12020386
Abstract
Despite recent discoveries in genetics and molecular fields, glioblastoma (GBM) prognosis still remains unfavorable with less than 10% of patients alive 5 years after diagnosis. Numerous studies have focused on the research of biological biomarkers to stratify GBM patients. We addressed this issue in our study by using clinical/molecular and image data, which is generally available to Neurosurgical Departments in order to create a prognostic score that can be useful to stratify GBM patients undergoing surgical resection. By using the random forest approach [CART analysis (classification and regression tree)] on Survival time data of 465 cases, we developed a new prediction score resulting in 10 groups based on extent of resection (EOR), age, tumor volumetric features, intraoperative protocols and tumor molecular classes. The resulting tree was trimmed according to similarities in the relative hazard ratios amongst groups, giving rise to a 5-group classification tree. These 5 groups were different in terms of overall survival (OS) (p < 0.000). The score performance in predicting death was defined by a Harrell’s c-index of 0.79 (95% confidence interval [0.76–0.81]). The proposed score could be useful in a clinical setting to refine the prognosis of GBM patients after surgery and prior to postoperative treatment.This publication has 55 references indexed in Scilit:
- New prognostic factors and calculators for outcome prediction in patients with recurrent glioblastoma: A pooled analysis of EORTC Brain Tumour Group phase I and II clinical trialsEuropean Journal of Cancer, 2012
- Survival Analysis of Patients with High-Grade Gliomas Based on Data Mining of Imaging VariablesAmerican Journal of Neuroradiology, 2012
- Extent of resection influences outcomes for patients with gliomasRevue Neurologique, 2011
- Genomic profiling of glioblastoma: convergence of fundamental biologic tenets and novel insightsJournal of Neuro-Oncology, 2011
- Evidence for potentials and limitations of brain plasticity using an atlas of functional resectability of WHO grade II gliomas: Towards a “minimal common brain”NeuroImage, 2011
- Molecular Predictors of Progression-Free and Overall Survival in Patients With Newly Diagnosed Glioblastoma: A Prospective Translational Study of the German Glioma NetworkJournal of Clinical Oncology, 2009
- Gliadel (BCNU) wafer plus concomitant temozolomide therapy after primary resection of glioblastoma multiformeJournal of Neurosurgery, 2009
- Role of Extent of Resection in the Long-Term Outcome of Low-Grade Hemispheric GliomasJournal of Clinical Oncology, 2008
- Radiotherapy plus Concomitant and Adjuvant Temozolomide for GlioblastomaThe New England Journal of Medicine, 2005
- A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survivalJournal of Neurosurgery, 2001