Multivariate Analysis Of Prognostic Factors In Patients With Glioma

Objective：To analyze the relationship between clinical factors and prognosis inbrain glioma. To provide the theoretical reference as prognosis and treatment forglioma patients.Methods：The data of81brain glioma patients treated in the Department ofNeurosurgery, the First Affiliated Hospital of Fujian Medical University was collectedfrom January2002to November2011. The prognosis was analyzed by Cox multivariatemodel. P<0.05indicated that the factor was related to the survival. Kaplan-Meieranalysis was used to draw the survivorship curves. Subjective: male56cases (69.1%),female25cases (30.9%);71(87.7%) were younger than60and10(12.3%) were over60. The cases of pathological grade (WHO2007) Ⅱ, Ⅲ and Ⅳ were20(24.7%),33(40.7%) and28(34.6%), respectively; there were73cases (90.1%) whose imageappeared preoperative surrounding edema; the preoperative Karnofsky PerformanceScale (KPS) score:12cases (14.8%) were below70,69cases (85.2%) were over70;58cases (71.6%) presented headache and24cases (29.6%) had the epilepsy symptmbefore surgery;64patients (79.0%) received total resection and17(21%) receivedsubtotal resection.70cases (86.4%) received radiotherapy after surgery in all of thepatients. All patients received chemotherapy after operative,77cases (95.1%)seleceted temozolomide (TMZ) as chemotherapy drug, in which18cases (22.2%)were treated less than four courses while59cases (72.8%) received four or more.There were56cases in81detected Ki-67which expressed in12cases (14.8%) below10%, while another38cases (54.3%) expressed over10%. There were42casesdetected the expression of O6-methylguanine-DNA-methyltransferase (MGMT) whichexpressed negative in8cases (9.9%), positive in34cases (42.0%).Results：Through Cox’s multivariate logistic regression analysis, there are6factors may be related to the prognosis of patients with glioma, they are preoperativeKarnosky Performance Scale (KPS) score, age, pathology grade, postoperativeradiotherapy, the courses of treatment of temozolomide (TMZ) and the expression level of Ki-67.Conclusion：Age, pathology grade, preoperative Karnofsky Performance Scale(KPS) score, postoperative radiotherapy, the expression level of Ki-67areindependent factors which might affect the prognostic of patients with glioma. Thepatients with older age, lower preoperative KPS, higher pathological grade and higherlevel of Ki-67have poorer prognosis. Postoperative radiotherapy and enoughadequate chemotherapy using TMZ will be helpful to improve the prognosis ofglioma.