Impact of Infection on Survival Outcomes in High-Grade Gliomas: A Retrospective Analysis of 26 Cases in Our Fifteen-Year Experience—Janus Faced Phenomenon
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients Selection and Treatment Protocol
2.2. Data Collection and Patient Cohort
2.3. Statistical Analysis
3. Results
3.1. Characteristics of the HGG Patients with Infection and Age-Matched Case–Control Population
3.2. The Survival Data of All the Selected 56 Cohort Patients with HGG—The Infected and Uninfected Groups Together
3.3. Comparison of Survival Data Between the Infected and Uninfected Groups of HGG Patients
3.3.1. OS Analysis Between the Infected and Uninfected Groups of HGG Patients
3.3.2. OS Analysis Between the Infected and Uninfected HGG Groups Based on Their IDH Mutations Status
3.4. The Microbiological Results of HGG Patients with Postoperative Infection
3.4.1. Case Reports of Three HGG Patients with Long Survival (>3-Years)
Case Report 1
Case Report 2
Case Report 3
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
GBM | GBM |
KPS | Karnofsky Performance Score |
WHO | Word Health Organization |
IDH | isocitrate dehydrogenase |
OS | overall survival |
PFS | progression free survival |
SSI | surgical site infection |
SSI-MEN | surgical site infection—meningitis |
SSI-IC | surgical site infection—intracranial abscess |
SSI-CRAN | surgical site infection—craniotomy |
ATRX | Alpha-thalassemia X-linked mutant retardation syndrome |
TMZ | temozolomide |
CT | computed tomography |
MRI | Magnetic Resonance Imaging |
ASA | acetyl salicylic acid |
HGG | high-grade glioma |
AA | anaplastic astrocytoma |
MHC | major histocompatibility complex |
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Characteristics of the Patients | Patients with Infections (26) | Age-Matched Controls (26) |
---|---|---|
Mean age (years) (min–max) | 56 (30–75) | 56 (33–77) |
Male (%) | 17 (65%) | 16 (61.5%) |
Localization (%) | ||
frontal | 10 (38%) | 9 (35%) |
occipital | 1 (4%) | 1 (4%) |
temporal | 8 (31%) | 10 (38%) |
parietal | 7 (27%) | 6 (23%) |
Postoperative infection (%) | ||
SSI | 7 (27%) | 0 |
SSI-IC | 13 (50%) | 0 |
SSI-MEN | 3 (11.5%) | 0 |
SSI-CRAN | 3 (11.5%) | 0 |
PFS (days) | ||
mean | 343 | 309 |
median | 179 | 259 |
OS (days) | ||
mean | 674 | 442 |
median | 388 | 422 |
Patients | Age at Diagnosis (Years) | Localization | Reoperation | IDH-Type | ATRX | Ki-67 % | PFS (Days) | OS (Days) | Infection Type | Time Elapsed After Surgery and Infection (Days) | Microbiological Results |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | 50 | temporal | yes | IDH-wild | neg | 45 | 80 | 202 | SSI-MEN | 5 | Escherichia coli, Enterococcus faecalis |
2 | 56 | frontal | no | IDH-wild | pos | 30 | 176 | 539 | SSI-IC | 170 | ND |
3 | 60 | frontal | yes | IDH-wild | pos | 22.5 | 54 | 54 | SSI-IC | 21 | negative |
4 | 49 | temporal | yes | ND | ND | ND | 378 | 1075 | SSI | 954 | Staphylococcus aureus |
5 | 73 | temporal | yes | IDH-wild | pos | 30 | 147 | 753 | SSI-IC | 202 | Staphylococcus epidermidis |
6 | 53 | temporal | yes | IDH-wild | pos | 20 | 39 | 416 | SSI-IC | 15 | ND |
7 | 57 | parietal | yes | IDH-mutant | neg | 25 | 327 | 327 | SSI-IC | 217 | Klebsiella aerogenes |
8 | 60 | parietal | yes | IDH-wild | pos | ND | 234 | 285 | SSI-IC | 68 | negative |
9 | 51 | frontal | yes | IDH-wild | neg | 15 | 182 | 322 | SSI-IC | 217 | negative |
10 | 68 | parietal | yes | ND | pos | 55 | 162 | 181 | SSI-IC | 45 | Propionibacterium acnes |
11 | 65 | frontal | yes | IDH-wild | neg | 20 | 57 | 57 | SSI-IC | 25 | negative |
12 | 67 | frontal | yes | IDH-wild | pos | 27.5 | 27 | 197 | SSI-IC | 102 | Staphylococcus epidermidis, Cutibacterium acnes |
13 | 64 | parietal | yes | IDH-wild | pos | ND | 1096 | 2406 | SSI-IC | 2356 | Enterobacter cloacae, Peptoniphilus species, Peptococcus niger Actinomyces turicensis |
14 | 56 | parietal | yes | ND | ND | 20 | 173 | 243 | SSI | 229 | ND |
15 | 48 | parietal | yes | ND | ND | ND | 516 | 516 | SSI-CRAN | 487 | Methicillin resistant Staphylococcus aureus, Pseudomonas aeruginosa |
16 | 53 | parietal | yes | IDH-wild | pos | 15 | 60 | 315 | SSI-CRAN | 68 | negative |
17 | 58 | frontal | no | IDH-wild | pos | 25 | 289 | 961 | SSI | 14 | negative |
18 | 57 | temporal | yes | IDH-wild | pos | 40 | 462 | 700 | SSI-IC | 484 | Staphylococcus epidermidis |
19 | 30 | frontal | ND | IDH-mutant | neg | 40 | 2116 | 2402 | SSI-CRAN | 2175 | Staphylococcus aureus |
20 | 75 | temporal | yes | ND | ND | ND | 950 | 978 | SSI | 96 | Methicillin-resistant Staphylococcus aureus |
21 | 63 | temporal | no | IDH-wild | pos | 22.5 | 106 | 106 | SSI | 35 | negative |
22 | 35 | frontal | no | IDH-mutant | pos | 45 | 933 | 1079 | SSI | 6 | negative |
23 | 37 | occipital | no | IDH-wild | pos | 25 | 1818 | 2051 | SSI | 1943 | negative |
24 | 48 | frontal | yes | IDH-wild | pos | 22.5 | 702 | 858 | SSI-IC | 33 | negative |
25 | 52 | temporal | yes | IDH-mutant | neg | 17.5 | 359 | 359 | SSI-MEN | 10 | Enterococcus faecalis, Staphylococcus epidermidis |
26 | 37 | frontal | yes | IDH-mutant | neg | 55 | 145 | 145 | SSI-MEN | 20 | negative |
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Berényi, G.; Szabó, D.; Agócs, G.; Andrássy, B.; Fedorcsák, I.; Erőss, L.; Sipos, L. Impact of Infection on Survival Outcomes in High-Grade Gliomas: A Retrospective Analysis of 26 Cases in Our Fifteen-Year Experience—Janus Faced Phenomenon. Cancers 2025, 17, 1348. https://doi.org/10.3390/cancers17081348
Berényi G, Szabó D, Agócs G, Andrássy B, Fedorcsák I, Erőss L, Sipos L. Impact of Infection on Survival Outcomes in High-Grade Gliomas: A Retrospective Analysis of 26 Cases in Our Fifteen-Year Experience—Janus Faced Phenomenon. Cancers. 2025; 17(8):1348. https://doi.org/10.3390/cancers17081348
Chicago/Turabian StyleBerényi, György, Dóra Szabó, Gergely Agócs, Blanka Andrássy, Imre Fedorcsák, Loránd Erőss, and László Sipos. 2025. "Impact of Infection on Survival Outcomes in High-Grade Gliomas: A Retrospective Analysis of 26 Cases in Our Fifteen-Year Experience—Janus Faced Phenomenon" Cancers 17, no. 8: 1348. https://doi.org/10.3390/cancers17081348
APA StyleBerényi, G., Szabó, D., Agócs, G., Andrássy, B., Fedorcsák, I., Erőss, L., & Sipos, L. (2025). Impact of Infection on Survival Outcomes in High-Grade Gliomas: A Retrospective Analysis of 26 Cases in Our Fifteen-Year Experience—Janus Faced Phenomenon. Cancers, 17(8), 1348. https://doi.org/10.3390/cancers17081348