The relative value of postoperative versus preoperative Karnofsky Performance Scale scores as a predictor of survival after surgical resection of glioblastoma multiforme

The Karnofsky Performance Scale (KPS) score is a widespread metric to stratify patient prognosis and determine appropriate management in glioblastoma multiforme(GBM). Low preoperative KPS values have been associated with shorter overall survival (OS). However, surgical resection can have a dramatic...

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Bibliographic Details
Published in:Journal of neuro-oncology 2015, Vol.121 (2), p.359-364
Main Authors: Chambless, Lola B., Kistka, Heather M., Parker, Scott L., Hassam-Malani, Laila, McGirt, Matthew J., Thompson, Reid C.
Format: Article
Language:English
Subjects:
Age Factors
Aged
Brain - radiation effects
Brain - surgery
Brain Neoplasms - complications
Brain Neoplasms - diagnosis
Brain Neoplasms - radiotherapy
Brain Neoplasms - surgery
Clinical Study
Diabetes Complications
Female
Follow-Up Studies
Glioblastoma - complications
Glioblastoma - diagnosis
Glioblastoma - radiotherapy
Glioblastoma - surgery
Humans
Kaplan-Meier Estimate
Karnofsky Performance Status
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Oncology
Postoperative Period
Preoperative Period
Prognosis
Retrospective Studies
Treatment Outcome
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Summary:The Karnofsky Performance Scale (KPS) score is a widespread metric to stratify patient prognosis and determine appropriate management in glioblastoma multiforme(GBM). Low preoperative KPS values have been associated with shorter overall survival (OS). However, surgical resection can have a dramatic effect on a patient’s functional status which subsequently alters their KPS score. To determine the predictive value of preoperative verses postoperative KPS scores in terms of OS in patients with GBM. We conducted a retrospective review of 163 patients who underwent initial surgical intervention for pathologically proven GBM at our institution between 2003 and 2013. Pre and postoperative performance status, demographic, operative, and treatment variables were recorded for each patient. Multivariate regression analysis identified predictors of prolonged OS. The adequacy index was calculated to compare the predictive value of preoperative and postoperative KPS score. Median preoperative and postoperative KPS scores were 70 and 80, respectively. Overall, 92 (57 %) patients experienced an improvement in their KPS score, 40 (25 %) remained stable, and 29 (18 %) declined. Higher postoperative KPS ( P  = 0.0001), radiation therapy ( P  
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-014-1640-x