Introduction: Glioblastoma(GBM) is the most common and aggressive malignant brain tumor in adult of which peritumoral edema is an important feature. Peritumoral edema adds to mass effect of gliblastoma and makes the symptoms of patients more severe, but it is still controversial whether peritumoral edema has an influence on overall survival of those patients. The aim of our study was to assess the prognosis value of parameters associated with edema in patients with glioblastoma.
Methods: Preoperative magnetic resonance imaging (MRI) of 78 patients with newly diagnosed supratentorial glioblastoma were retrospective reviewed. The Kaplan-Meier method, COX proportional hazard model and stepwise regression analysis were applied to evaluate the impact on overall survival of preoperative MRI features (including peritumaral edema, tumor size, edema shape, and edema crosses midline) and demographic variables (such as age, gender, preoperative Karnofsky performance status (KPS) and postoperative KPS).
Results: Age, tumor size, edema size and tumor volume were found to be independent prognostic indicator for poorer overall survival in Kaplan-Meier method, while postoperative KPS, not preoperative KPS, indicated a better survival. Age, tumor volume and postoperative KPS remained significantly associated with overall survival in COX proportional hazard model analysis.
Conclusions: No edema parameter in preoperative MRI was found to be significantly associated with overall survival of patients with glioblastoma in our retrospective study.
Patient Care: Although no significant relationship was found between edema parameters in preoperative MRI and overall survival of patients with glioblastoma, we found a strong correlation between postoperative KPS, not preoperative KPS, and outcome, which may add importance to safe resection more than maximum resection.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the relationship between peritumoral edema and overall survival in patients with glioblastoma, 2) Discuss, in small groups, the potential reason for which a greater edema didn’t lead to a worse outcome.