Background and Purpose:
The importance of tumor volume as a prognostic factor in high-grade gliomas is highly controversial and there are numerous methods estimating this parameter. In this study, a computer-based application was used in order to assess tumor volume from hard copies and a survival analysis was conducted in order to evaluate the prognostic significance of preoperative volumetric data in patients harboring glioblastomas.
Patients and Methods:
50 patients suffering from glioblastoma were analyzed retrospectively. Tumor volume was determined by the various geometric models as well as by an own specialized software (Volumio). Age, performance status, type of excision, and tumor location were also included in the multivariate analysis.
Results:
The spheroid and rectangular models overestimated tumor volume, while the ellipsoid model offered the best approximation. Volume failed to attain any statistical significance in prognosis, while age and performance status confirmed their importance in progression-free and overall survival of patients.
Conclusion:
Geometric models provide a rough approximation of tumor volume and should not be used, as accurate determination of size is of paramount importance in order to draw safe conclusions in oncology. Although the significance of volumetry was not disclosed, further studies are definitely required.
Hintergrund und Ziel:
Die Bedeutung des Tumorvolumens als prognostischer Faktor fur maligne Gliome ist nach wie vor umstritten. In dieser Studie wurden eine computerbasierte Methode zur Beurteilung des Tumorvolumens anhand von magnetresonanztomographischen Bildern bei Patienten mit Glioblastoma multiforme (GBM) durchgefuhrt und mittels einer Uberlebensanalyse die prognostische Bedeutung praoperativer volumetrischer Daten untersucht.
Patienten und Methodik:
50 Patienten mit GBM, welche zwei unterschiedliche Chemotherapieregime erhalten hatten, wurden retrospektiv analysiert und die Tumorvolumina durch verschiedene geometrische Modelle sowie eine spezielle Software (Volumio) gemessen. Alter, Performance-Status, Tumorlokalisation sowie Art der Exzision wurden in der multivariaten Uberlebensanalyse berucksichtigt.
Ergebnisse:
Die angewandten spharoiden und rektangularen geometrischen Modelle uberschatzten das Tumorvolumen, wohingegen die ellipsoiden Modelle die beste Annaherung im Vergleich zu Volumio ermoglichten. Das Tumorvolumen erwies sich nicht als statistisch signifikanter Prognosefaktor. In der multivariaten Analyse bestatigte sich die Bedeutung des Alters und des Performance-Status fur das progressionsfreie Uberleben und das Gesamtuberleben der Patienten.
Schlussfolgerung:
Geometrische Modelle bieten eine ungenaue Messung des Tumorvolumens und sollten in der klinischen Praxis nicht zur Anwendung kommen, zumal die prazise Erfassung der Tumorgrose von entscheidender onkologischer Bedeutung ist. Obwohl die vorgelegten Daten den Einfluss des Tumorvolumens als statistisch nicht signifikant zeigten, sind weitere Studien bezuglich der Bedeutung dieses Parameters notwendig.
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Iliadis, G., Selviaridis, P., Kalogera-Fountzila, A. et al. The Importance of Tumor Volume in the Prognosis of Patients with Glioblastoma. Strahlenther Onkol 185, 743–750 (2009). https://doi.org/10.1007/s00066-009-2015-7
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DOI: https://doi.org/10.1007/s00066-009-2015-7