We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
A Simple Preoperative Blood Count to Stratify Prognosis in Isocitrate Dehydrogenase-Wildtype Glioblastoma Patients Treated with Radiotherapy plus Concomitant and Adjuvant Temozolomide.
- Authors
Clavreul, Anne; Lemée, Jean-Michel; Soulard, Gwénaëlle; Rousseau, Audrey; Menei, Philippe
- Abstract
Simple Summary: Glioblastoma (GB) is the most common primary malignant brain tumor in adulthood. The median survival of patients is approximately 15 months after the standard therapy including safe maximal resection followed by radiotherapy plus concomitant and adjuvant temozolomide. However, the survival times of GB patients undergoing this treatment are heterogeneous, with a small fraction living even beyond 36 months. The identification of a reliable and simple method for predicting whether patients will be short- or long-term survivors could assist in shaping individualized posttreatment surveillance. We show here that a simple, low-cost, relatively innocuous blood test before surgery can predict the survival outcomes of patients with isocitrate dehydrogenase (IDH)-wildtype GB treated with the standard therapy. Purpose: The survival times of glioblastoma (GB) patients after the standard therapy including safe maximal resection followed by radiotherapy plus concomitant and adjuvant temozolomide are heterogeneous. In order to define a simple, reliable method for predicting whether patients with isocitrate dehydrogenase (IDH)-wildtype GB treated with the standard therapy will be short- or long-term survivors, we analyzed the correlation of preoperative blood counts and their combined forms with progression-free survival (PFS) and overall survival (OS) in these patients. Methods: Eighty-five patients with primary IDH-wildtype GB treated with the standard therapy between 2012 and 2019 were analyzed retrospectively. Cox proportional hazards models and Kaplan–Meier analysis were used to investigate the survival function of preoperative hematological parameters. Results: Preoperative high neutrophil-to-lymphocyte ratio (NLR, >2.42), high platelet count (>236 × 109/L), and low red blood cell (RBC) count (≤4.59 × 1012/L) were independent prognostic factors for poorer OS (p = 0.030, p = 0.030, and p = 0.004, respectively). Moreover, a high NLR was an independent prognostic factor for shorter PFS (p = 0.010). We also found that, like NLR, preoperative high derived NLR (dNLR, >1.89) was of poor prognostic value for both PFS (p = 0.002) and OS (p = 0.033). A significant correlation was observed between NLR and dNLR (r = 0.88, p < 0.001), which had a similar prognostic power for OS (NLR: AUC = 0.58; 95% CI: [0.48; 0.68]; dNLR: AUC = 0.62; 95% CI: [0.51; 0.72]). Two scores, one based on preoperative platelet and RBC counts plus NLR and the other on preoperative platelet and RBC counts plus dNLR, were found to be independent prognostic factors for PFS (p = 0.006 and p = 0.002, respectively) and OS (p < 0.001 for both scores). Conclusion: Cheap, routinely ordered, preoperative assessments of blood markers, such as NLR, dNLR, RBC, and platelet counts, can predict the survival outcomes of patients with IDH-wildtype GB treated with the standard therapy.
- Subjects
SURVIVAL; PREDICTIVE tests; ACQUISITION of data methodology; CONFIDENCE intervals; PREOPERATIVE period; BLOOD platelets; GLIOMAS; RETROSPECTIVE studies; ADJUVANT treatment of cancer; CHEMORADIOTHERAPY; NEUTROPHILS; LYMPHOCYTES; TEMOZOLOMIDE; SURVIVAL analysis (Biometry); MEDICAL records; KAPLAN-Meier estimator; DESCRIPTIVE statistics; TUMOR markers; PROPORTIONAL hazards models
- Publication
Cancers, 2021, Vol 13, Issue 22, p5778
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers13225778