GLIOBLASTOMA MULTIFORME – OUTCOMES AND EXPERRIENCES AT A TERTIARY CARE HOSPITAL

Dr. Puneet Kant, Dr. Mahima Singh, Dr. Ajay Choudhary, Dr. L N Gupta

Abstract


Background - Glioblastoma Multiforme (GBM) is the most common primary brain tumour in adults. Although the survival rate for GBM has improved with recent advancements in treatment, the prognosis remains generally poor.

Method - We conducted a retrospective review of GBM patients seen in PGIMER & Dr. Ram Manohar Lohia Hospital, New Delhi from August 2015 to September 2017. Demographic data and clinicopathological data and treatment parameters were collected from the hospital medical records and correlated with patient survival.

Results – Data of 71 GBM patients including 3 pediatric patients was analysed. We observed an increase in incidence with increasing age with majority patients being in the age group of 50 – 60 years. Majority of our patients (28.2%) had a preoperative Karnofsky Performance Score (KPS) of 80 and 19.7% patients had a KPS of <50. All our patients were subjected to either near total or subtotal tumour resection depending on clinical features, radiological profile and intraoperative findings. After discharge, the treatment was continued with radiotherapy and adjuvant concurrent chemotherapy in all patients. The patient survival after discharge from hospital ranged from 2 months to 13 months with a median survival time of 6 months. 11 patients expired during their stay in the ICU. Using the Spearman’s Rho test significant correlation between poor preoperative Karnofsky Performance Score (KPS) and poor survival was seen (correlation coefficient = 0.435, p= 0.01). Treatment with near total tumour resection, radiotherapy and adjuvant concurrent chemotherapy correlated with improved survival (p= 0.043) in comparison to patients subjected to subtotal tumour resection and chemoradiotherapy.  The correlation between patient survival and patient age is very weak and insignificant (p = 0.12) in our patient group. The approximate total blood loss was tabulated and mean blood loss during surgery was found to be 1504.23 ml ± 554.059 ml. Type of resection showed no correlation with duration (in days) of postoperative ventilation ( p = 0.284) and duration of ICU stay (p = 0.358).

Conclusion - GBM confers a poor prognosis especially at extremes of age. Extent of surgical resection, preoperative KPS show direct association with improved survival.

 


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References


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