SUPRATENTORIAL GLIOMA : PROGNOSTIC FACTORS AND OUTCOME

 

Ali R. Hamdan 1, Momen M. Al Mamoun 2, Mahmoud H. Ragab3 ,

Ahmad I. Elgheriany 4  

1Department of neurosurgery Faculty of medicine, South Valley University, Qena, Egypt

2 Department of neurosurgery Faculty of medicine, Sohag University, Sohag, Egypt

3, 4 Department of neurosurgery Faculty of medicine, Assiut University, Egypt

 ABSTRACT

Objective: To identify characteristics and prognostic factors for survival in adult patients with cerebral gliomas. This study aims to evaluate the different prognostic factors for survival in patients with supratentorial gliomas. Patients & Methods: It's a clinical retrospective and prospective study harboring supratentorial glioma that includes surgical management of 92 patients harboring supratentorial glioma and the effect of different prognostic factors on the outcomes starting from November 2008 and followed up for 2 years at department of neurosurgery, Assiut University Hospital. Surgery was performed for all patients by using different surgical modalities. The patient variables including; age, sex, KPS, clinical presentation mainly seizure, tumor variables including; size, mass effect, histopathological grade and treatment variables including different surgical modalities; biopsy, debulking and gross total resection were tested for their prognostic significance. All the statistical data processing, tables and graphs were conducted by the (SPSS statistical data package for Microsoft Windows) and survival rates were calculated using the Kaplan-Meier method. Results: Median patient age was 46.5years (mean, 44.8; range, 12-70 years), the male-female ratio was 1.6:1. Fifty seven patients (62%) were males while thirty five patients (38%) were females. Median survival for the entire population studied was 6 months (95% CI = 3.988 – 8.012%). Prognostic factors: Using univariate analysis, six favourable prognostic factors were identified: young age (<45 years), clinical presentation mainly seizure Karnofski performance status ≥70, smaller tumor size, extensive surgery and low-grade histology. Conclusion: this study showed that age, KPS, tumor size, histological grade, and extent of surgery, dose of radiation are significant prognostic factors in patients with supratentorial glioma.