Prognostic Factors Influencing Clinical Outcomes of Malignant Glioblastoma Multiforme: Clinical, Immunophenotypic, and Fluorescence in Situ Hybridization Findings for 1p19q in 816 Chinese Cases

Malignant glioblastoma multiforme (GBM) is the most malignant brain tumor and despite recent advancesin diagnostics and treatment prognosis remains poor. In this retrospective study, we assessed the clinical andradiological parameters, as well as fluorescence in situ hybridization (FISH) of 1p19q deletion, in a series ofcases. A total of 816 patients with GBM who received surgery and radiation between January 2010 and May2014 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to findthe factors independently influencing patient progression free survival (PFS) and overall survival (OS). Age atdiagnosis, preoperative Karnofsky Performance Scale (KPS) score, KPS score change at 2 weeks after operation,neurological deficit symptoms, tumor resection extent, maximal tumor diameter, involvement of eloquent cortexor deep structure, involvement of brain lobe, Ki-67 and MMP9 expression level and adjuvant chemotherapywere statistically significant factors (p<0.05) for both PFS and OS in the univariate analysis. Cox proportionalhazards modeling revealed that age ≤50 years, preoperative KPS score ≥80, KPS score change after operation ≥0,involvement of single frontal lobe, deep structure involvement, low Ki-67 and MMP9 expression and adjuvantchemotherapy were independent favorable factors (p<0.05) for patient clinical outcomes.