• Venkatesh S Madhugiri, Aliasgar V Moiyadi, Prakash Shetty, Tejpal Gupta, Sridhar Epari, Rakesh Jalali, Venkatesan Subeikshanan, Akshat Dutt, Gopalakrishnan M Sasidharan, V R Roopesh Kumar, C V Shankar Ganesh, Andi Sadayandi Ramesh, and Sathia PrabhuAADepartment of Neurosurgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India..
• Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India. Electronic address: venkatesh@nimhans.ac.in.
• World Neurosurg. 2021 May 1; 149: e758-e765.

BackgroundSome patients with glioblastoma multiforme (GBM) survive 3-5 years (or longer) after diagnosis. The goal of this study was to identify differences between the long-term survivors (LTS) and those who had a shorter overall survival (non-LTS groups).MethodsThis study was a retrospective analysis of prospectively maintained surgical databases. All patients who underwent safe maximal resection for GBM were included. Demographic, clinical, radiologic, and pathologic data were obtained from electronic medical records. Values of the biomarkers of systemic inflammation were computed from the preoperative hemogram reports. Patients with an overall survival (OS) ≥36 months were defined as the LTS group and were compared with the non-LTS groups (OS<36 months).ResultsPatients in the LTS group were younger, had a better baseline performance status, and were more likely to have undergone near- or gross-total resection. LTS was associated with lower Ki67 labeling, MGMT methylation, IDH mutation, and lack of p53 overexpression. Several novel findings were generated by this study. A longer pretreatment duration of symptoms was associated with a longer OS. Higher pretreatment levels of the absolute neutrophil count, neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, derived neutrophil-lymphocyte ratio and systemic index of inflammation, and lower levels of the absolute eosinophil count and eosinophil-lymphocyte ratio all correlated with a shorter OS.ConclusionsSeveral differences were identified between the LTS and non-LTS groups. These differences will likely be incorporated into future prognostic models. They may also aid in differentiation between recurrent disease and treatment-related changes.Copyright © 2021 Elsevier Inc. All rights reserved.

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