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Tumour size and overall survival in a cohort of patients with unifocal glioblastoma: a uni- and multivariable prognostic modelling and resampling study
Fatania, K. Frood, R. Mistry, Hitesh Short, S. C. O'Connor, James Scarsbrook, A. F. Currie, S.
Fatania, K.
Frood, R.
Mistry, Hitesh
Short, S. C.
O'Connor, James
Scarsbrook, A. F.
Currie, S.
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Abstract
Published models inconsistently associate glioblastoma size with overall survival (OS). This study aimed to investigate the prognostic effect of tumour size in a large cohort of patients diagnosed with GBM and interrogate how sample size and non-linear transformations may impact on the likelihood of finding a prognostic effect. In total, 279 patients with a IDH-wildtype unifocal WHO grade 4 GBM between 2014 and 2020 from a retrospective cohort were included. Uni-/multivariable association between core volume, whole volume (CV and WV), and diameter with OS was assessed with (1) Cox proportional hazard models +/- log transformation and (2) resampling with 1,000,000 repetitions and varying sample size to identify the percentage of models, which showed a significant effect of tumour size. Models adjusted for operation type and a diameter model adjusted for all clinical variables remained significant (p = 0.03). Multivariable resampling increased the significant effects (p < 0.05) of all size variables as sample size increased. Log transformation also had a large effect on the chances of a prognostic effect of WV. For models adjusted for operation type, 19.5% of WV vs. 26.3% log-WV (n = 50) and 69.9% WV and 89.9% log-WV (n = 279) were significant. In this large well-curated cohort, multivariable modelling and resampling suggest tumour volume is prognostic at larger sample sizes and with log transformation for WV.
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Date
2024
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Fatania K, Frood R, Mistry H, Short SC, O'Connor J, Scarsbrook AF, et al. Tumour Size and Overall Survival in a Cohort of Patients with Unifocal Glioblastoma: A Uni- and Multivariable Prognostic Modelling and Resampling Study. Cancers (Basel). 2024 Mar 27;16(7). PubMed PMID: 38610979. Pubmed Central PMCID: PMC11011077. Epub 2024/04/13. eng.