TY - JOUR
T1 - Routine Blood Tests Do Not Predict Survival in Patients with Glioblastoma—Multivariable Analysis of 497 Patients
AU - Maas, Sybren L.N.
AU - Draaisma, Kaspar
AU - Snijders, Tom J.
AU - Senders, Joeky T.
AU - Berendsen, Sharon
AU - Seute, Tatjana
AU - Schiffelers, Raymond M.
AU - van Solinge, Wouter W.
AU - Ten Berg, Maarten J.
AU - Robe, Pierre A.
AU - Broekman, Marike L.D.
N1 - Funding Information:
Conflict of interest statement: The present study was financially supported, in part, by the Hersenstichting Nederland (Foundation Concerned with Diseases of the Brain), the Schumacher Kramer Stichting, and the T & P Bohnenn Foundation.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Background: Multiple reports have attributed a prognostic value to routine blood tests results for patients with glioblastoma. However, these studies have reported conflicting results and have often had small sample sizes. We sought to validate the prognostic value of the described tests in an independent glioblastoma patient population. Methods: We performed a retrospective single-center multivariable analysis of 497 patients with glioblastoma who had postoperatively undergone radiotherapy and/or chemotherapy to identify the prognostic value for median overall survival of hemoglobin, white blood cell, monocyte, neutrophil, leukocyte, and platelet counts, neutrophil/lymphocyte ratio, C-reactive protein, erythrocyte sedimentation rate, activated partial thromboplastin time, prothrombin time, and lactate dehydrogenase. We also evaluated known prognostic factors for survival such as patient age, intervention type, IDH1 status, Karnofsky clinical performance status, and postoperative treatment modality. Results: In a multivariable model, after correcting for multiple testing bias, biopsy alone (hazard ratio, 0.35; 95% confidence interval, 0.26–0.49; false discovery rate-adjusted P < 0.001) and monotherapy after surgery (hazard ratio, 0.46; 95% confidence interval, 0.33–0.66; false discovery rate-adjusted P < 0.001) remained significantly associated with worse median overall survival. Patient age and Karnofsky performance status score ≥70 did not significantly influence survival in the multivariable model. No routine blood test included in the multivariable analysis was significantly associated with survival. Conclusions: In the present study, hemoglobin, white blood cell, monocyte, neutrophil, leukocyte, and platelet counts, neutrophil/lymphocyte ratio, C-reactive protein, erythrocyte sedimentation rate, activated partial thromboplastin time, prothrombin time, and lactate dehydrogenase levels did not independently predict for overall survival in patients with glioblastoma.
AB - Background: Multiple reports have attributed a prognostic value to routine blood tests results for patients with glioblastoma. However, these studies have reported conflicting results and have often had small sample sizes. We sought to validate the prognostic value of the described tests in an independent glioblastoma patient population. Methods: We performed a retrospective single-center multivariable analysis of 497 patients with glioblastoma who had postoperatively undergone radiotherapy and/or chemotherapy to identify the prognostic value for median overall survival of hemoglobin, white blood cell, monocyte, neutrophil, leukocyte, and platelet counts, neutrophil/lymphocyte ratio, C-reactive protein, erythrocyte sedimentation rate, activated partial thromboplastin time, prothrombin time, and lactate dehydrogenase. We also evaluated known prognostic factors for survival such as patient age, intervention type, IDH1 status, Karnofsky clinical performance status, and postoperative treatment modality. Results: In a multivariable model, after correcting for multiple testing bias, biopsy alone (hazard ratio, 0.35; 95% confidence interval, 0.26–0.49; false discovery rate-adjusted P < 0.001) and monotherapy after surgery (hazard ratio, 0.46; 95% confidence interval, 0.33–0.66; false discovery rate-adjusted P < 0.001) remained significantly associated with worse median overall survival. Patient age and Karnofsky performance status score ≥70 did not significantly influence survival in the multivariable model. No routine blood test included in the multivariable analysis was significantly associated with survival. Conclusions: In the present study, hemoglobin, white blood cell, monocyte, neutrophil, leukocyte, and platelet counts, neutrophil/lymphocyte ratio, C-reactive protein, erythrocyte sedimentation rate, activated partial thromboplastin time, prothrombin time, and lactate dehydrogenase levels did not independently predict for overall survival in patients with glioblastoma.
KW - Biomarkers
KW - Blood tests
KW - Glioblastoma
KW - Hemoglobin
KW - Prognostic markers
KW - Prognosticators
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85063955913&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2019.03.053
DO - 10.1016/j.wneu.2019.03.053
M3 - Article
C2 - 30880204
SN - 1878-8750
VL - 126
SP - e1081-e1091
JO - World Neurosurgery
JF - World Neurosurgery
ER -