CLO22-064: Presurgical Edema Volume Influences the Decision to Perform a Biopsy or a Complete Resection in Glioblastoma Patients

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  • 1 Hospital Universitario de Canarias, Tenerife, Spain

Background: Glioblastoma (GB) is the most frequent primary malignant brain tumor with a fateful prognosis despite standard treatment. The extent of surgical resection (EOR) is one of the most accepted prognostic factors in GB. Aim: To analyze the factors that are associated with an intention to achieve a complete resection in GB. Methods: A retrospective single-center case-series analysis of patients with a new diagnosis of GB (from January 2015 to December 2020) treated with Stupp scheme has been performed. Patients were distributed in two groups: biopsy (B) or complete-resection intention (CRI) groups. A binary-logistic-regression was performed to identify the factors associated to CRI. Furthermore, a Cox regression analysis was performed in each group of patients to identify factors associated with overall survival (OS) in each group. Results: Ninety-nine patients (mean age 61.18 [SD=11.45], 41 women) were included in the study. Sixty-eight patients (68.7%) belonged to the CRI group. CRI patients presented larger edema-volume in presurgical magnetic resonance imaging (MRI) (p=0.025) and a higher necrosis-tumor ratio (p=0.035). As expected, CRI patients showed a higher OS than those in the B group (15.6 vs. 10.1 months; p=0.002). The univariate binary-logistic-regression showed that contrast-ring-enhancement (OR=2.445; p=0.046) and the edema-volume in presurgical-MRI (OR=1.019; p=0.013) were both associated with the intention for a complete removal. Only the edema volume reach significancy in the multivariate analysis (OR=1.017; p=0.027). Finally, the survival analysis showed that contrast-enhancement volume was the only studied variable associated with a worse OS in B patients (HR=1.031; p=0.017), while the presence of epileptic seizures (HR=2.123; p=0.039) and the MGMT methylation (HR=0.448; p=0.009) were both associated with OS in CRI patients. Conclusion: Larger edema volume in presurgical MRI may be associated with a higher intention to achieve a complete removal in GB patients. Prognostic factors associated with OS are different in B and CRI patients.

Corresponding Author: Carla María Martín-Abreu
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