Multi-center study finds postoperative residual non-enhancing component of glioblastoma as a new determinant of patient outcome.

Kotrotsou, Aikaterini; Elakkad, Ahmed; Sun, Jia; Thomas, Ginu A; Yang, Dongni; Abrol, Srishti; Wei, Wei; Weinberg, Jeffrey S; Bakhtiari, Ali S; Kircher, Moritz F; Lüdi, Markus; de Groot, John F; Sawaya, Raymond; Kumar, Ashok J; Zinn, Pascal O; Colen, Rivka R (2018). Multi-center study finds postoperative residual non-enhancing component of glioblastoma as a new determinant of patient outcome. Journal of neuro-oncology, 139(1), pp. 125-133. Springer 10.1007/s11060-018-2850-4

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INTRODUCTION The aim of the present study is to assess whether postoperative residual non-enhancing volume (PRNV) is correlated and predictive of overall survival (OS) in glioblastoma (GBM) patients. METHODS We retrospectively analyzed a total 134 GBM patients obtained from The University of Texas MD Anderson Cancer Center (training cohort, n = 97) and The Cancer Genome Atlas (validation cohort, n = 37). All patients had undergone postoperative magnetic resonance imaging immediately after surgery. We evaluated the survival outcomes with regard to PRNV. The role of possible prognostic factors that may affect survival after resection, including age, sex, preoperative Karnofsky performance status, postoperative nodular enhancement, surgically induced enhancement, and postoperative necrosis, was investigated using univariate and multivariate Cox proportional hazards regression analyses. Additionally, a recursive partitioning analysis (RPA) was used to identify prognostic groups. RESULTS Our analyses revealed that a high PRNV (HR 1.051; p-corrected = 0.046) and old age (HR 1.031; p-corrected = 0.006) were independent predictors of overall survival. This trend was also observed in the validation cohort (higher PRNV: HR 1.127, p-corrected  = 0.002; older age: HR 1.034, p-corrected  = 0.022). RPA analysis identified two prognostic risk groups: low-risk group (PRNV < 70.2 cm; n = 55) and high-risk group (PRNV ≥ 70.2 cm; n = 42). GBM patients with low PRNV had a significant survival benefit (5.6 months; p = 0.0037). CONCLUSION Our results demonstrate that high PRNV is associated with poor OS. Such results could be of great importance in a clinical setting, particularly in the postoperative management and monitoring of therapy.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Lüdi, Markus


600 Technology > 610 Medicine & health








Jeannie Wurz

Date Deposited:

24 Apr 2018 15:51

Last Modified:

22 Oct 2019 20:07

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Glioblastoma Invasion Postoperative Survival




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