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Peritumoral edema shown by MRI predicts poor clinical outcome in glioblastoma.

Wu CX, Lin GS, Lin ZX, Zhang JD, Liu SY, Zhou CF - World J Surg Oncol (2015)

Bottom Line: The aim of this study was to assess the prognostic value of preoperative MRI features in patients with glioblastoma.Furthermore, patients with two unfavorable conditions (major edema and necrosis) had a shorter overall survival compared with the remainder.Our data confirm that peritumoral edema extent and necrosis are helpful for predicting poor clinical outcome in glioblastoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China. albert978@126.com.

ABSTRACT

Background: Magnetic resonance imaging (MRI) plays an irreplaceable role in the preoperative diagnosis of glioma, and its imaging features are the base of making treatment decisions in patients with glioma, but it is still controversial whether peritumoral edema shown by MRI from preoperative routine scans are associated with patient survival. The aim of this study was to assess the prognostic value of preoperative MRI features in patients with glioblastoma.

Methods: A retrospective review of 87 patients with newly diagnosed supratentorial glioblastoma was performed using medical records and MRI data from routine scans. The Kaplan-Meier method and COX proportional hazard model were applied to evaluate the prognostic impact on overall survival of pretreatment MRI features (including peritumoral edema, edema shape, necrosis, cyst, enhancement, tumor crosses midline, edema crosses midline, and tumor size).

Results: In addition to patient age, Karnofsky performance status (KPS) and postoperative chemoradiotherapy, peritumoral edema extent and necrosis on preoperative MRI were independent prognostic indicator for poor survival. Furthermore, patients with two unfavorable conditions (major edema and necrosis) had a shorter overall survival compared with the remainder.

Conclusions: Our data confirm that peritumoral edema extent and necrosis are helpful for predicting poor clinical outcome in glioblastoma. These features were easy to determine from routine MRI scans postoperatively and therefore could provide a certain instructive significance for clinical activities.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier curves. Kaplan-Meier curves showing correlations of PTE (A), edema shape (B), enhancement necrosis (C), enhancement (D), age (E), KPS (F), chemoradiotherapy (G), and major PTE and necrosis (H) with overall survival in the entire cohort.
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Fig2: Kaplan-Meier curves. Kaplan-Meier curves showing correlations of PTE (A), edema shape (B), enhancement necrosis (C), enhancement (D), age (E), KPS (F), chemoradiotherapy (G), and major PTE and necrosis (H) with overall survival in the entire cohort.

Mentions: To evaluate the influence of on prognosis, telephone or outpatient visit was applied in the entire cohort (followed up time minimum 101 days, maximum 1,198 days, median 352 days), and corresponding OS was calculated. Out of 87 patients, the median OS was 435 days (95% CI 374 to 495) in the entire cohort. Univariate analysis (Table 3) revealed major PTE was shown to be significantly associated with a dismal OS (P = 0.019, Figure 2A) and patients with minor PTE exhibited longer survival compared with major edema. Additionally, similar results were obtained for edema shape (P = 0.007, Figure 2B), necrosis (P = 0.000, Figure 2C), enhancement (P = 0.003, Figure 2D), patient age (P = 0.001, Figure 2E), KPS (P = 0.005, Figure 2F), and chemoradiotherapy (P = 0.013, Figure 2G). However, no significant difference was observed among OS with gender, cyst, tumor crosses midline, edema crosses midline, and tumor size (P > 0.05).Table 3


Peritumoral edema shown by MRI predicts poor clinical outcome in glioblastoma.

Wu CX, Lin GS, Lin ZX, Zhang JD, Liu SY, Zhou CF - World J Surg Oncol (2015)

Kaplan-Meier curves. Kaplan-Meier curves showing correlations of PTE (A), edema shape (B), enhancement necrosis (C), enhancement (D), age (E), KPS (F), chemoradiotherapy (G), and major PTE and necrosis (H) with overall survival in the entire cohort.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4358863&req=5

Fig2: Kaplan-Meier curves. Kaplan-Meier curves showing correlations of PTE (A), edema shape (B), enhancement necrosis (C), enhancement (D), age (E), KPS (F), chemoradiotherapy (G), and major PTE and necrosis (H) with overall survival in the entire cohort.
Mentions: To evaluate the influence of on prognosis, telephone or outpatient visit was applied in the entire cohort (followed up time minimum 101 days, maximum 1,198 days, median 352 days), and corresponding OS was calculated. Out of 87 patients, the median OS was 435 days (95% CI 374 to 495) in the entire cohort. Univariate analysis (Table 3) revealed major PTE was shown to be significantly associated with a dismal OS (P = 0.019, Figure 2A) and patients with minor PTE exhibited longer survival compared with major edema. Additionally, similar results were obtained for edema shape (P = 0.007, Figure 2B), necrosis (P = 0.000, Figure 2C), enhancement (P = 0.003, Figure 2D), patient age (P = 0.001, Figure 2E), KPS (P = 0.005, Figure 2F), and chemoradiotherapy (P = 0.013, Figure 2G). However, no significant difference was observed among OS with gender, cyst, tumor crosses midline, edema crosses midline, and tumor size (P > 0.05).Table 3

Bottom Line: The aim of this study was to assess the prognostic value of preoperative MRI features in patients with glioblastoma.Furthermore, patients with two unfavorable conditions (major edema and necrosis) had a shorter overall survival compared with the remainder.Our data confirm that peritumoral edema extent and necrosis are helpful for predicting poor clinical outcome in glioblastoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China. albert978@126.com.

ABSTRACT

Background: Magnetic resonance imaging (MRI) plays an irreplaceable role in the preoperative diagnosis of glioma, and its imaging features are the base of making treatment decisions in patients with glioma, but it is still controversial whether peritumoral edema shown by MRI from preoperative routine scans are associated with patient survival. The aim of this study was to assess the prognostic value of preoperative MRI features in patients with glioblastoma.

Methods: A retrospective review of 87 patients with newly diagnosed supratentorial glioblastoma was performed using medical records and MRI data from routine scans. The Kaplan-Meier method and COX proportional hazard model were applied to evaluate the prognostic impact on overall survival of pretreatment MRI features (including peritumoral edema, edema shape, necrosis, cyst, enhancement, tumor crosses midline, edema crosses midline, and tumor size).

Results: In addition to patient age, Karnofsky performance status (KPS) and postoperative chemoradiotherapy, peritumoral edema extent and necrosis on preoperative MRI were independent prognostic indicator for poor survival. Furthermore, patients with two unfavorable conditions (major edema and necrosis) had a shorter overall survival compared with the remainder.

Conclusions: Our data confirm that peritumoral edema extent and necrosis are helpful for predicting poor clinical outcome in glioblastoma. These features were easy to determine from routine MRI scans postoperatively and therefore could provide a certain instructive significance for clinical activities.

No MeSH data available.


Related in: MedlinePlus