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Open AccessArticle

Retrospective and Randomized Analysis of Influence and Correlation of Clinical and Molecular Prognostic Factors in a Mono-Operative Series of 122 Patients with Glioblastoma Treated with STR or GTR

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Department of Neurological Sciences, Neurosurgey, “La Sapienza” University of Rome, 00161 Rome, Italy
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Department of Anatomical, Histological, Forensic Medicine and Orthopedic Science, “La Sapienza” University of Rome, 00161 Rome, Italy
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UOSD of Neurophysiopathology and DISMOV, AOU G Martino, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
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Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Dingjiaqiao 87, Nanjing 210009, China
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Department of Psychology, Faculty of Medicine and Psychology “La Sapienza” University of Rome, 00189 Rome, Italy
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Department of Neurosurgery, IRCCS Neuromed Pozzilli IS, 86077 Isernia, Italy
*
Author to whom correspondence should be addressed.
Brain Sci. 2020, 10(2), 91; https://doi.org/10.3390/brainsci10020091
Received: 28 December 2019 / Revised: 29 January 2020 / Accepted: 7 February 2020 / Published: 9 February 2020
(This article belongs to the Collection Collection on Clinical Neuroscience)
Glioblastoma is a solid, infiltrating, and the most frequent highly malignant primary brain tumor. Our aim was to find the correlation between sex, age, preoperative Karnofsky performance status (KPS), presenting with seizures, and extent of resection (EOR) with overall survival (OS), progression-free survival (PFS), and postoperative KPS, along with the prognostic value of IDH1, MGMT, ATRX, EGFR, and TP53 genes mutations and of Ki67 through the analysis of a single-operator series in order to avoid the biases of a multi-operator series, such as the lack of homogeneity in surgical and adjuvant nonsurgical treatments. A randomized retrospective analysis of 122 patients treated by a single first operator at Sapienza University of Rome was carried out. After surgery, patients followed standard Stupp protocol treatment. Exclusion criteria were: (1) patients with primary brainstem and spinal cord gliomas and (2) patients who underwent partial resections (resection < 90%) or a biopsy exclusively for diagnostic purposes. Statistical analysis with a simultaneous regression model was carried out through the use of SPSS 25® (IBM). Results showed statistically significant survival increase in four groups: (1) patients treated with gross total resection (GTR) (p < 0.030); (2) patients with mutation of IDH1 (p < 0.0161); (3) patients with methylated MGMT promoter (p < 0.005); (4) patients without EGFR amplification or EGFRvIII mutation (p < 0.035). Higher but not statistically significant survival rates were also observed in: patients <75 years, patients presenting with seizures at diagnosis, patients affected by lesions in noneloquent areas, as well as in patients with ATRX gene mutation and Ki-67 < 10%. View Full-Text
Keywords: Glioblastoma multiforme; GTR; STR; KPS; IDH1; MGMT; ATRX; EGFR; TP53; Ki67; Neurosurgery; Oncology; Epilepsy Glioblastoma multiforme; GTR; STR; KPS; IDH1; MGMT; ATRX; EGFR; TP53; Ki67; Neurosurgery; Oncology; Epilepsy
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Salvati, M.; Bruzzaniti, P.; Relucenti, M.; Nizzola, M.; Familiari, P.; Giugliano, M.; Scafa, A.K.; Galletta, S.; Li, X.; Chen, R.; Barbaranelli, C.; Frati, A.; Santoro, A. Retrospective and Randomized Analysis of Influence and Correlation of Clinical and Molecular Prognostic Factors in a Mono-Operative Series of 122 Patients with Glioblastoma Treated with STR or GTR. Brain Sci. 2020, 10, 91.

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