Prognostic Impact of the Combination of Methylation and Promoter Mutation in Glioblastoma.

The concept of combinational analysis between the methylation of ( ) and promoter ( ) mutation in glioblastoma (GBM) has been reported. The main study objective was to determine the prognosis of patients with GBM based on classification, while the secondary objective was to estimate the temozolomide effect on the survival time of GBM with classification.  A total of 50 GBM specimens were collected after tumor resection and were selected for investigating methylation and mutation. Clinical imaging and pathological characteristics were retrospectively analyzed. Patients with classification were analyzed using survival analysis to develop the nomogram for forecasting and individual prognosis.  All patients underwent resection (total resection: 28%, partial resection: 64%, biopsy: 8%). Thirty-two percent of all cases received adjuvant temozolomide with radiotherapy. Sixty-four percent of the case was found methylated , and 56% of the present cohort found mutation. Following combinational analysis of biomarkers, results showed that the GBMs with methylated and wild-type had a superior prognosis compared with other subtypes. Using Cox regression analysis with multivariable analysis, the extent of resection, postoperative chemoradiotherapy, classification were associated with a favorable prognosis. Hence, a web-based nomogram was developed for deploying individual prognostication.  The interaction of methylation and mutation was confirmed for predicting prognosis. The results from the present study could help physicians create treatment strategies for GBM patients in real-world situations.