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A retrospective analysis of the risk factors affecting recurrence time in patients with recurrent glioblastoma

Ann Palliat Med. 2021 May;10(5):5391-5399. doi: 10.21037/apm-21-823. Epub 2021 May 12.

Abstract

Background: This study explored the related factors that influence the recurrence time of glioblastomas (GBM).

Methods: A retrospective study of recurrent GBM patients with surgical resection was performed. Recurrence time was analyzed using Kaplan-Meier survival curves. The Cox regression model was used to investigate the possible factors associated with recurrence time.

Results: A total of 176 patients (113 males and 63 females) were enrolled in the study, with a median age of 57 years (range, 19-76 years). From this cohort, 18 patients (10.2%) had gross total resection (GTR), 53 patients (30.1%) had subtotal resection (STR), and 105 patients (59.7%) had partial resection (PR). Postoperatively, all patients received radiotherapy (RT), with 55.1% administered concurrent chemotherapy (CTh) and 59.7% administered adjuvant CTh. The median recurrence time was 10.0 months (range, 1.0-75.0 months). Patients with PR (P=0.004), gliomas that contacted the subventricular zone (SVZ) (P=0.004), isocitrate dehydrogenase 1 (IDH1) wild-type (P=0.048), telomerase reverse transcriptase (TERT) C228T wild-type (P=0.012), and positive glial fibrillary acidic protein (GFAP) expression (P=0.044) had a shortened time to recurrence. Cox regression analysis revealed that PR (P=0.036), SVZ contact (P=0.008), and TERT C228T wild type (P=0.023) were significantly associated with a shortened recurrence time.

Conclusions: PR, tumor contacting the SVZ, and TERT C228T wild type were independent risk factors for tumor recurrence in patients with GBM.

Keywords: Recurrent glioblastoma; isocitrate dehydrogenase 1 (IDH1); recurrence; subventricular zone (SVZ); surgical resection.

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms* / radiotherapy
  • Female
  • Glioblastoma*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Young Adult