Which Parameter Is More Important for the Prognosis of New-Onset Adult Glioblastoma: Residual Tumor Volume or Extent of Resection?

Abstract

The extent of resection (EOR) and residual tumor volume (RTV) are 2 pivotal predictors influencing the survival of patients with new-onset adult glioblastoma. Which of these 2 factors is more important remains unclear, however. The present aimed to evaluate and compare the accuracy of EOR and RTV, based on contrast-enhancing (CE) T1-weighted magnetic resonance imaging (MRI) and T2-weighted/fluid-attenuated inversion recovery (F) MRI, as prognostic factors in these patients. In this retrospective study, data were extracted from the databases of 2 hospitals between January 1, 2013, and December 31, 2015. The subjects were divided into 2 groups, the total resection group and the partial resection group. The analysis comprised EOR and RTV. Statistical analysis was performed after controlling for other relevant factors. We analyzed 292 patients with new-onset glioblastoma who met the inclusion criteria. In the partial resection group, univariate analysis revealed that CE-EOR, CE-RTV, F-EOR, and F-RTV were correlated with progression-free survival (PFS) and overall survival (OS), but multivariate analysis identified no correlation between CE-EOR or F-EOR and PFS or OS. In the total resection group, F-EOR and F-RTV were correlated with PFS and OS in univariate analysis, but F-EOR was not correlated in multivariate analysis. Regardless of total or partial CE tumor resection, EOR might not be an independent prognostic factor. In contrast, RTV has the potential to offer greater predictive power for the prognosis of new-onset adult glioblastoma. Further investigations of the correlations of RTV and EOR with survival in patients with new-onset glioblastoma are needed.