The treatment effect of gliomas and prognostic factor analysis: a reports of 741 cases

Objective To review the treatment effect of brain gliomas and to investigate the clinical factors influencing the patients′ outcomes. Methods A total of 741 patients were enrolled into this retrospective study who underwent their first operation and were diagnosed as primary brain gliomas at Neurosurgery Department of Sun Yat-sen University Cancer Center between January 2000 and December 2016. The patients were treated with various adjuvant therapies after operation. Survival difference between gliomas with varying tumor pathology and treatment methods were evaluated by Kaplan-Meier method with log-rank test. The multivariate Cox regression analysis of the clinical factors related to the patient′s outcome was performed. Results A total of 741 patients with follow-up data were reviewed. Tumor total resection and subtotal resection were respectively achieved in 482 (65.0%) and 115 (15.5%) patients. Sixty-four cases were diagnosed as WHO grade Ⅰ glioma, 194 as grade Ⅱ, 191 as grade Ⅲ and 292 as grade Ⅳ. At a median follow-up of 17.0 months (1-188 months), 314 patients were died. The median overall survival (OS) of patients with grade Ⅰ, Ⅱ, Ⅲ, Ⅳ gliomas were not reached (>76.0 months), 123.0 (107.5-139.4) months, 33.0 (25.5-40.5) months and 17.0 (15.3-18.8) months, respectively. The survival was decreased with the increase of pathological grades of gliomas (χ2=138.200, P 73.0 months)] than those undergoing surgery only [54.8 (24.9-84.7) months, P=0.004]. In addition, multivariate analysis revealed that age, histology type, extent of tumor resection and postoperative radiotherapy and chemotherapy were independent factors associated with OS of high-grade gliomas (all P<0.05). For low-grade gliomas, Postoperative radiotherapy or chemotherapy could improve the survival of patients with Low-grade gliomas. age, tumor pathology and resection extent of tumor were independent prognostic factors (all P<0.05). Conclusions Postoperative radiotherapy and chemotherapy could improve the survival of patients with high-grade gliomas. Age, tumor pathology and resection extent of tumor seem to be major factors related to the clinical outcome of brain gliomas. Key words: Glioma; Combined modality therapy; Treatment outcome; Prognosis; Root cause analysis