Abstract
Despite the wide reportage of prognostic factors for glioblastoma (GBM), it is difficult
to determine how these factors interact to affect patients’ survival. To determine
the combination of prognostic factors, we retrospectively analyzed the clinic data
of 248 IDH wild-type GBM patients and built a novel prediction model. The survival
variables of patients were identified via univariate and multivariate analyses. In
addition, the score prediction models were constructed by combining classification
and regression tree (CART) analysis with Cox regression analysis. Finally, the prediction
model was internally validated using the bootstrap method. Patients were followed
for a median of 34.4 (interquartile range, 26.1–46.0) months. Multivariate analysis
identified gross total resection (GTR) (HR 0.50, 95% CI: 0.38–0.67), unopened ventricles
(HR 0.75 [0.57–0.99]), and MGMT methylation (HR 0.56 [0.41–0.76]) as favorable independent
prognostic factors for PFS. GTR (HR 0.67 [0.49–0.92]), unopened ventricles (HR 0.60
[0.44–0.82]), and MGMT methylation (HR 0.54 [0.38–0.76]) were favorable independent
prognostic factors for OS. In the process of building the model, we incorporated GTR,
ventricular opening, MGMT methylation status, and age. The model had six and five
terminal nodules in PFS and OS respectively. We grouped terminal nodes with similar
hazard ratios together to form three sub-groups with different PFS and OS (P < 0.001).
After the internal verification of bootstrap method, the model had a good fitting
and calibration. GTR, unopened ventricles, and MGMT methylation were independently
associated with more satisfactory survival. The novel score prediction model which
we construct can provide a prognostic reference for GBM.
Keywords
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Article info
Publication history
Published online: April 12, 2023
Accepted:
April 1,
2023
Received in revised form:
March 28,
2023
Received:
December 21,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
