• Uroš Smrdel, Andreja Cirila Škufca Smrdel, Anja Podlesek, Marija Skoblar Vidmar, Gregor Kos, Jana Markovic, Jana Jereb, Jana Knific, and Tina Rus.
• Uroš Smrdel, Institute of Oncology Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia, usmrdel@onko-i.si.
• Croat. Med. J. 2023 Dec 31; 64 (6): 383390383-390.

AimTo investigate the prognostic factors of survival in patients with high-grade gliomas without isocitrate dehydrogenase-1 (IDH) mutation and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation.MethodsThe study enrolled Slovenian patients with high-grade gliomas. Postoperatively, they completed a battery of neuropsychological tests. Demographics and clinical data were collected. The results of cognitive tests were converted to standardized scores and dichotomized based on impairment. A univariate Cox proportional hazard regression model was used to determine clinical predictors, and a multivariate Cox model was used to determine the prognostic value of cognitive test results. Kaplan-Meier curves were constructed, and survival was compared with the log rank test.ResultsThe study enrolled 49 patients with IDH wild-type, MGMT-unmethylated high-grade gliomas. The median time to progression was 9.92 months (7.25, 12.59) and the overall median survival was 12.19 months (8.95, 15.4). Age and the extent of surgery were significant prognostic factors for survival. After controlling for these factors, cognitive functioning in the domain of verbal fluency remained a significant predictor of survival outcomes.ConclusionCognitive functioning in the domain of verbal fluency was associated with overall survival independently of age and the extent of surgery. Cognitive functioning could be an important stratifying tool in this group of patients lacking other predictors.

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