Factors affecting the survival of patients with glioblastoma multiforme.

PURPOSE: Glioblastoma multiforme (GBM) is the most aggressive malignant tumor in the brain and no therapy can achieve full recovery/cure. The aim of this study was to identify which factors could improve the survival of operated patients, and to determine which kind of therapy was most successful.

METHODS: The study was conducted at the Clinic for Neurosurgery in Nis, Clinical Centre Nis and the Oncology Institute, Clinical Center Nis. A cohort of patients who underwent surgery between January 2013 and December 2015 was studied and continuous monitoring of survival lasted until June 2017.

RESULTS: Patients who underwent only biopsy have 3.82- fold greater chance of death than patients with complete tumor resection (HR 3,825; p=0.001). Karnofsky performance status score significantly affected survival (preoperatively and postoperatively; p<0.001). Apart from radiotherapy, three types of chemotherapy were applied: carmustine (BCNU) - 32.80% of the patients, procarbazine/lomustine/ vincristine (PCV) - 38.80% and temozolomide - 28.40%. Kaplan-Meier overall survival showed that patients treated with temozolomide had the longest survival compared to patients treated with BCNU and/or PCV chemotherapy.

CONCLUSION: The best prognosis was seen in those patients who had complete tumor resection. Patients treated with temozolomide had the best survival compared with those treated with BCNU and PCV chemotherapy.