Raysi Dehcordi S, De Paulis D, Marzi S, Ricci A, Cimini A, Cifone M G, Galzio R J
Department of Health Sciences, University of L'Aquila, L'Aquila, Italy.
J Neurosurg Sci. 2012 Sep;56(3):239-45.
Approximate survival for glioblastoma is less than 1 year. Age, histological features and performance status at presentation represent the three statistically independent factors affecting longevity. The purpose of the study was to assess the role of surgery and to analyze prognostic factors in our patients operated for glioblastoma.
We evaluated in 56 patients operated for glioblastoma their depressive and performance status in the preoperative and postoperative time. Moreover we analyzed the extent of surgery, the site and the size of lesions.
Median overall survival was 17 months. An age of ≥60 years (P<0.03), a preoperative Karnofsky Performance Status KPS≤70 (P=0.04), a subtotal tumor resection (P<0.001), a tumor size >5 cm (P=0.01), and no postoperative adjuvant treatment (P=0.01) were associated with the worst prognosis. Before surgery we found the presence of depression in 10 patients with a significative reduction of mean Back Depression Inventory scores after tumor resection (P=0.03). Finally, a KPS≤70 was significantly associated with an increased incidence of depression in the postoperative time.
Tumor size, total resection and affective disorders were identified as predictors of survival in our series of patients with glioblastoma in addition to age and KPS score. In our opinion an early diagnosis and the use of specific safeguards in the operating room contribute to have an extension of the tumor progression time and median survival.
胶质母细胞瘤的近似生存期不到1年。就诊时的年龄、组织学特征和功能状态是影响生存期的三个统计学上独立的因素。本研究的目的是评估手术的作用，并分析我们收治的接受胶质母细胞瘤手术患者的预后因素。
我们评估了56例接受胶质母细胞瘤手术患者术前和术后的抑郁及功能状态。此外，我们分析了手术范围、病变部位和大小。
总生存期的中位数为17个月。年龄≥60岁（P<0.03）、术前卡氏功能状态评分（KPS）≤70（P=0.04）、肿瘤次全切除（P<0.001）、肿瘤大小>5 cm（P=0.01）以及未进行术后辅助治疗（P=0.01）与最差预后相关。术前我们发现10例患者存在抑郁，肿瘤切除后平均背部抑郁量表评分显著降低（P=0.03）。最后，KPS≤70与术后抑郁发生率增加显著相关。
除年龄和KPS评分外，肿瘤大小、全切除及情感障碍被确定为我们这组胶质母细胞瘤患者生存的预测因素。我们认为早期诊断以及在手术室采取特定的防护措施有助于延长肿瘤进展时间和中位生存期。
