Preoperative Survival Prediction in Patients With Glioblastoma by Routine Inflammatory Laboratory Parameters

Anticancer Res. 2020 Feb;40(2):1161-1166. doi: 10.21873/anticanres.14058.

Abstract

Background: Glioblastoma (GBM) is the most common malignant brain tumor in adults and still carries a dismal prognosis. As several studies detected a connection between inflammation and GBM prognosis, we sought to explore possible associations between routinely investigated inflammatory parameters and GBM outcome.

Patients and methods: Patients treated for GBM at our Institution between 2004 and 2014 were included. White blood cell count (WBC), C-reactive protein (CRP) and the ratio of platelets and WBC (Plt/WBC) were evaluated preoperatively. Medical records were reviewed for clinical parameters (age, sex, preoperative clinical condition, genetic alterations). Study endpoints were overall (OS) and 1- and 2-year survival.

Results: In the final cohort consisting of 565 individuals with GBM, univariate analysis showed significant associations for WBC, CRP and Plt/WBC ratio with OS. Kaplan-Meier survival plot confirmed significantly poorer OS in patients with WBC>12/nl and with CRP≥2.9 mg/dl. In multivariate analysis, a WBC of >12/nl was an independent prognostic factor for all three outcome parameters and CRP≥2.9 mg/dl for OS and 1-year survival.

Conclusion: Preoperative WBC and CRP values were confirmed as independent predictors of GBM outcome. This emphasizes the need for further evaluation of the role of inflammation in the prognosis of GBM.

Keywords: Glioblastoma; inflammation; routine laboratory parameter.

MeSH terms

  • Adult
  • Aged
  • Biomarkers*
  • Brain Neoplasms / etiology
  • Brain Neoplasms / metabolism*
  • Brain Neoplasms / mortality*
  • Brain Neoplasms / surgery
  • C-Reactive Protein
  • Female
  • Glioblastoma / etiology
  • Glioblastoma / metabolism*
  • Glioblastoma / mortality*
  • Glioblastoma / surgery
  • Humans
  • Inflammation Mediators
  • Kaplan-Meier Estimate
  • Leukocyte Count
  • Male
  • Middle Aged
  • Preoperative Period
  • Prognosis
  • Retrospective Studies

Substances

  • Biomarkers
  • Inflammation Mediators
  • C-Reactive Protein