Utilidad de la evaluación volumétrica con resonancia magnética en la valoración inicial y postquirúrgica de gliomas de alto grado

Abstract

Glioblastoma is still the most common malignant brain tumor with a very short expected survival, even with early treatment. The main goal of this study was to determine if there were differences in survival depending on residual tumor and preoperative tumor volumes calculated on pre and post-surgery magnetic resonance imaging (MRI). The secondary goals were to analyze patients who underwent partial vs complete resection and to identify if certain tumor locations, patient’s age, level on post-surgery Karnofsky scale and molecular subtypes were associated with better outcomes. Methods: 395 patients from different institutions were retrospectively reviewed from 2011 to 2019 and the observation period finished on June 2021. Only adults with confirmed primary glioblastoma grade IV IDH wild type and with good quality of MRI images were included. Pre- and post-contrast 3D T1 MRI weighted images were evaluated to calculate pre and post-operative tumor volumes. Kaplan-Meier analysis was performed on both volumes, EOR, presurgical area, age, type of surgery, KPS post-surgery, molecular subtype, tumor’s location and the hospital were the resection was performed. Chi-squaretest was performed to evaluate any relation between survival (following Sawaya et al. classification), type of surgery (partial vs complete resection) and adjuvant treatment. Kappa index was performed between the impression of the neurosurgeon after the surgery and the report of the neuroradiologist in the postsurgical MRI. Spearman correlations were used to investigate any association between variables...