Uroš Smrdel, Institute of Oncology Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia,
Croat Med J. 2023 Dec 31;64(6):383-390. doi: 10.3325/cmj.2023.64.383.
To investigate the prognostic factors of survival in patients with high-grade gliomas without isocitrate dehydrogenase-1 (IDH) mutation and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation.
The study enrolled Slovenian patients with high-grade gliomas. Postoperatively, they completed a battery of neuropsychological tests. Demographics and clinical data were collected. The results of cognitive tests were converted to standardized scores and dichotomized based on impairment. A univariate Cox proportional hazard regression model was used to determine clinical predictors, and a multivariate Cox model was used to determine the prognostic value of cognitive test results. Kaplan-Meier curves were constructed, and survival was compared with the log rank test.
The study enrolled 49 patients with IDH wild-type, MGMT-unmethylated high-grade gliomas. The median time to progression was 9.92 months (7.25, 12.59) and the overall median survival was 12.19 months (8.95, 15.4). Age and the extent of surgery were significant prognostic factors for survival. After controlling for these factors, cognitive functioning in the domain of verbal fluency remained a significant predictor of survival outcomes.
Cognitive functioning in the domain of verbal fluency was associated with overall survival independently of age and the extent of surgery. Cognitive functioning could be an important stratifying tool in this group of patients lacking other predictors.
研究 IDH 突变和 O6-甲基鸟嘌呤-DNA 甲基转移酶（MGMT）启动子甲基化阴性的高级别胶质瘤患者的生存预后因素。
本研究纳入了斯洛文尼亚的高级别胶质瘤患者。术后，他们完成了一系列神经心理学测试。收集了人口统计学和临床数据。将认知测试的结果转换为标准分数，并根据损伤进行二分。采用单变量 Cox 比例风险回归模型确定临床预测因素，采用多变量 Cox 模型确定认知测试结果的预后价值。构建 Kaplan-Meier 曲线，并通过对数秩检验比较生存情况。
本研究纳入了 49 例 IDH 野生型、MGMT 未甲基化的高级别胶质瘤患者。无进展生存期的中位数为 9.92 个月（7.25，12.59），总生存期的中位数为 12.19 个月（8.95，15.4）。年龄和手术范围是生存的显著预后因素。在控制这些因素后，言语流畅性领域的认知功能仍然是生存结局的显著预测因素。
言语流畅性领域的认知功能与总生存期独立相关，与年龄和手术范围无关。在这群缺乏其他预测因素的患者中，认知功能可能是一个重要的分层工具。
