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- Jiaoming Li, Xiaodong Niu, Youjun Gan, Yuan Yang, Tianwei Wang, Haodongfang Zhang, Yanhui Liu, and Qing Mao.
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
- World Neurosurg. 2019 Aug 1; 128: e21-e30.
ObjectiveTo explore related factors that influence time to recurrence and prognosis of gliomas.MethodsA retrospective analysis of pathologic and clinical data of patients with glioma who underwent surgery for the first time and had a recurrence between 2009 and 2018 in West China Hospital was performed. Clinical characteristics of patients were reviewed, and survival analysis was performed to identify prognostic factors for the recurrent time. Molecules with differential changes in the paired samples were included in the survival analysis.ResultsA total of 84 patients met our inclusion requirements and were included in the study; other related factors were also considered in detail in the integrated analysis. Significant differences among O6-methylguanine-DNA methyltransferase (positive/negative), isocitrate dehydrogenase 1 (positive/negative), and Ki-67 were determined by statistical analysis of paired samples (P = 0.013, P = 0.014, P = 0.017). Univariate analysis demonstrated that Ki-67 (low expression, medium expression, high expression), initial World Health Organization grade (low or high), tumor side (left, right, middle), age (≥50 years, <50 years), and extent of resection were significantly correlated with time to recurrence (log-rank P = 0.008, P < 0.001, P = 0.015, P < 0.001, P = 0.001). Multivariate analysis results showed that Ki-67 lower expression (hazard ratio [HR] = 0.585, 95% confidence interval [CI] = 0.146-2.336, P = 0.448), medium expression (HR = 0.256, 95% CI = 0.084-0.784, P = 0.017), and high expression (HR = 1 as a reference) together with the initial World Health Organization grade (HR = 0.148, 95% CI = 0.029-0.749, P = 0.021) were independent predictive factors for glioma recurrence.ConclusionsThis comprehensive analysis revealed that initial World Health Organization grade and Ki-67 proliferative index were independent prognostic factors that predict the time to recurrence of glioma in patients after first surgery.Copyright © 2019 Elsevier Inc. All rights reserved.
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