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出院时的卡氏功能状态是胶质母细胞瘤患者预期寿命的预后指标。

The Karnofsky Performance Status at Discharge Is a Prognostic Indicator of Life Expectancy in Patients With Glioblastoma.

作者信息

Sasaki Shogo, Tsukamoto Shinji, Ishida Yukako, Kobayashi Yasuyo, Inagaki Yusuke, Mano Tomoo, Kitamura Tetsuro, Seriu Naoto, Nakagawa Ichiro, Kido Akira

机构信息

Rehabilitation Medicine, Nara Medical University, Kashihara, JPN.

Orthopedic Surgery, Nara Medical University, Kashihara, JPN.

出版信息

Cureus. 2024 Aug 5;16(8):e66226. doi: 10.7759/cureus.66226. eCollection 2024 Aug.

Abstract

Background Glioblastoma (GBM) is the most frequent invasive brain tumor and a rapidly progressive disease with a poor prognosis that predominantly affects middle-aged and older adults. The relationship between daily functioning and prognosis in patients with GBM will become more important as advances in multimodality treatment are expected to increase the number of long-term survivors. Methods Sixty-seven patients were initially diagnosed with GBM at our hospital between December 2013 and December 2022. All patients were divided into two groups: those who survived for one year or longer from the date of discharge (Group A) and those who died within one year from the date of discharge (Group B). Muscle strength, nutritional status, and Karnofsky Performance Status (KPS) were examined upon admission (p1), post-surgery (p2), and discharge (p3), and their relationships with prognosis were investigated. Results Group A was significantly younger than Group B, with a significant difference in the total radiation dose. There were no significant differences in the anatomical tumor location, whether the tumor occurred on the left or right side, or tumor size. KPS at discharge (p3) and the degree of improvement in the KPS between p1 and p3 were associated with a good prognosis. Conclusions The KPS varies throughout the treatment. When considering the KPS as a prognostic indicator, the KPS at discharge is the most important, given the structure of the disability and the course of treatment for GBM.

摘要

背景

胶质母细胞瘤(GBM)是最常见的侵袭性脑肿瘤,是一种进展迅速、预后不良的疾病,主要影响中老年人。随着多模态治疗的进展有望增加长期存活者的数量,GBM患者日常功能与预后之间的关系将变得更加重要。方法:2013年12月至2022年12月期间,我院共有67例初诊为GBM的患者。所有患者分为两组:出院日期起存活一年或更长时间的患者(A组)和出院日期起一年内死亡的患者(B组)。在入院时(p1)、手术后(p2)和出院时(p3)检查肌肉力量、营养状况和卡诺夫斯基功能状态(KPS),并研究它们与预后的关系。结果:A组比B组明显年轻,总辐射剂量有显著差异。在肿瘤的解剖位置、肿瘤发生在左侧还是右侧或肿瘤大小方面没有显著差异。出院时的KPS(p3)以及p1和p3之间KPS的改善程度与良好预后相关。结论:在整个治疗过程中,KPS会发生变化。考虑到GBM的残疾结构和治疗过程,将KPS作为预后指标时,出院时的KPS最为重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ad0/11376000/837b56f608c5/cureus-0016-00000066226-i01.jpg

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