Analysis of risk factors and prediction model establishment for early postoperative recurrence in glioma patients

doi:10.3760/cma.j.cn371439-20210121-00012

Abstract

Abstract:

Objective To investigate the related factors of early postoperative recurrence of glioma patients and to establish a prediction model for early recurrence. Methods A total of 94 patients with pathologically diagnosed glioma treated at Affiliated Hospital of Xuzhou Medical University from August 2014 to July 2016 were retrospectively analyzed. Kaplan-Meier method was used for survival analysis and log-rank test was carried out. Cox proportional risk regression model was used to analyze the clinical factors influencing early postoperative recurrence of glioma patients, and the prediction model of early recurrence was established. Results The recurrence rates were 26.6% (25/94) and 39.4% (37/94) at 12 months and 24 months after operation, respectively. Univariate analysis showed that age (χ²=9.59, P=0.008), degree of tumor resection (χ ²=14.26, P<0.001), Karnofsky performance status (KPS) score (χ ²=19.41, P<0.001), radiochemotherapy (χ ²=5.10, P=0.024) and pathological grade (χ ²=5.83, P=0.016) were significantly associated with early postoperative recurrence in glioma patients. Multivariate Cox proportional hazards regression model analysis showed that pathological grade (OR=2.64, 95%CI: 1.75-3.97, P<0.001), degree of resection (OR=0.34, 95%CI: 0.19-0.62, P<0.001) and radiochemotherapy (OR=2.58, 95%CI: 1.34-4.99, P=0.005) were independent factors influencing early postoperative recurrence in glioma patients. The risk function model expression of early recurrence in glioma patients was h(t)=h₀exp(0.970X₁-1.081X₂+0.949X₃). X₁, X₂ and X₃ represented pathological grade, resection degree and radiochemotherapy respectively. Conclusion High grade pathology and the absence of radiochemotherapy are independent predictors of early recurrence in glioma patients, and complete tumor resection can reduce the risk of early recurrence and improve the prognosis. The model of early recurrence prediction can provide some reference for clinical diagnosis and treatment.

Key words: Glioma, Early recurrence, Risk factors, Prediction model

Zhu Yishuo, Cui Yujie, Liu Qi, Li Jun, Fan Yuechao. Analysis of risk factors and prediction model establishment for early postoperative recurrence in glioma patients[J]. Journal of International Oncology, 2022, 49(2): 79-83.

Figures/Tables 2

References 21

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临床病理特征	例数	中位无复发生存时间(月)	χ²值	P值
性别
男	56	12.0	0.71	0.398
女	38	15.5
年龄(岁)
<30	19	25.0
30~50	46	14.5	9.59	0.008
>50	29	11.0
肿瘤部位
额叶	31	15.0
颞叶	16	13.0	3.31	0.347
顶叶	7	15.0
其他	40	11.0
肿瘤大小(cm)
<4	52	15.0	0.17	0.685
≥4	42	12.0
切除程度
部分切除	33	12.0	14.26	<0.001
完全切除	61	14.0
KPS评分
<70分	34	9.0	19.41	<0.001
≥70分	60	18.0
放化疗
否	41	12.0	5.10	0.024
是	53	15.0
病理分级
Ⅰ~Ⅱ	45	19.0	5.83	0.016
Ⅲ~Ⅳ	49	8.0

危险因素	β值	SE值	Wald值	P值	OR值	95%CI
病理分级	0.97	0.21	21.62	<0.001	2.64	1.75~3.97
切除程度	-1.08	0.30	12.63	<0.001	0.34	0.19~0.62
放化疗	0.95	0.34	7.98	0.005	2.58	1.34~4.99