Onco-functional outcome after resection for eloquent glioblastoma (OFO): A propensity-score matched analysis of an international, multicentre, cohort study

作者：Jasper K W Gerritsen, Rania Angelia Mekary, Dana Pisică, Rosa Hanne Zwarthoed, John L Kilgallon, Noah Nawabi, Charissa Jessurun, Georges Versyck, Ahmed Moussa, Hicham Bouhaddou, Koen Pepijn Pruijn, Fleur L. Fisher, Emma Larivière, Lien Solie, Alfred Kloet, Rishi Nandoe Tewarie, Joost W. Schouten, Eelke M. Bos, Clemens M.F. Dirven, Martin Jacques van den Bent, Susan M. Chang, Timothy R. Smith, Marike L. D. Broekman, Arnaud Jean Pierre Edouard Vincent, Steven De Vleeschouwer · 发表于：European Journal of Cancer · 年份：2024 · DOI：10.1016/j.ejca.2024.114311 · 被引用次数：12 · 研究领域：Glioma Diagnosis and Treatment、Brain Metastases and Treatment、Meningioma and schwannoma management

BACKGROUND: The combined impact of complete resection (oncological goal) and no functional loss (functional goal) in glioblastoma subgroups is currently unknown. This study aimed to develop a novel onco-functional outcome (OFO) to merge these two goals into one outcome, resulting in four classes: complete without deficits (OFO1), incomplete without deficits (OFO2), complete with deficits (OFO3), or incomplete with deficits (OFO4). METHODS: Between 2010-2020, 858 patients with tumor resection for eloquent glioblastoma were included. We analyzed the impact of OFO class on postoperative surgical outcomes using Cox proportional-hazards models with hazard ratios (HR) or logistic regression with odds ratios (OR), followed by specific subgroup analyses. We developed a risk model to predict OFO class preoperatively using logistic regression. RESULTS: The OFO classification stratified the four OFO classes for overall survival (OS:19.0 versus 14.0 versus 12.0 versus 9.0 months), progression-free survival (PFS), and adjuvant therapy. OFO1 was associated with improved OS [HR= 0.67, (0.55-0.81); p < 0.001], and PFS [HR = 0.68, (0.57-0.81); p < 0.001] in the overall cohort and all clinical and molecular subgroups, except for MGMT-unmethylated tumors; and higher rate of adjuvant therapy [OR= 2.81, (1.71-4.84);p < 0.001]. In patients≥ 70 years, only OFO1 improved their survival outcomes. Safe surgery was especially important in patients with a preoperative KPS ≤ 80 to qualify for adjuvant tr...