Glioblastoma multiforme -: report of 267 cases treated at a single institution

Objective: Glioblastoma multiforme (GBM) is the most common and most malignant primary brain tumor in adults. We present 267 cases treated at a single institution and discuss clinical characteristics and prognostic factors with regard to the neurosurgical literature. Methods: Included in this study were 267 patients who underwent craniotomy for newly diagnosed GBM between 1990 and 2001 at our department. Clinical charts and radiographic images were reviewed. Association to patient survival was estimated using log-rank test. Results: Median patient age was 61 years (mean, 59.5; range, 22-86 years), the male-female ratio was 1.2:1. In 35 cases (13.1%) the tumor was multicentric. Most of the tumors were classified as primary GBM (87.6%). During follow-up, 72 patients (26.4%) underwent recraniotomy for GBM recurrence and 3 patients (1.1%) developed spinal drop metastases. Overall median survival was 47 weeks (range, 5-305 weeks). The following parameters were significantly associated with prolonged survival: (1) age 61 years or younger, P < .001; (2) Karnofsky performance scale score of 70 or more, P < .001; (3) radiotherapy with a total dose of at least 54 Gy, P < .001; (4) chemotherapy, P < .001; (5) total tumor resection, P = .014; (6) recraniotomy for GBM recurrence, P = .012. Conclusions: Glioblastoma multiforme remains an important cause of morbidity and mortality from intracranial tumors. The overall prognosis is dismal, although interdisciplinary therapy can significantly prolong survival and allows a small subgroup of patients to survive 3 years or more. (C) 2005 Elsevier Inc. All rights reserved.