Background
Methods
Study design and participants
Data collection and variable selection
Demographic and Clinical Data | PRa (n = 367) | Controls(n = 2029) | t/Z/χ2 | p value |
---|---|---|---|---|
Preoperative Period | ||||
Age at Diagnosis (Years) | 54.61 (13.29), 6.00–78.00 | 43.25 (13.93), 3.00–82.00 | t = 14.95 | < 0.0001**** |
Sex male No. (%) | 245 (67) | 1152 (57) | χ2 = 12.74 | 3.59 × 10− 4*** |
Illness Duration (Months) | 3.97 (15.74), 0.10–240.00 | 5.73 (14.40), 0.05–240.00 | t = -1.96 | 0.05 |
Headache No. (%) | 184 (50) | 754 (37) | χ2 = 21.96 | < 0.0001**** |
Dizziness No. (%) | 44 (12) | 288 (14) | χ2 = 1.27 | 0.26 |
Nausea No. (%) | 16 (4) | 75 (4) | χ2 = 0.37 | 0.54 |
Vomiting No. (%) | 32 (9) | 142 (7) | χ2 = 1.37 | 0.24 |
Epilepsy No. (%) | 8 (2) | 161 (8) | χ2 = 15.70 | < 0.0001**** |
Intracranial Space-Occupying Lesion or Intracranial Tumora No. (%) | 6 (2) | 125 (6) | χ2 = 12.32 | 4.49 × 10− 4*** |
Impaired Consciousness No. (%) | 41 (11) | 416 (21) | χ2 = 17.53 | < 0.0001**** |
Muscle Twitching No. (%) | 39 (11) | 439 (22) | χ2 = 23.59 | < 0.0001**** |
Muscle Weakness No. (%) | 84 (23) | 232 (11) | χ2 = 35.61 | < 0.0001**** |
Limb Numbness No. (%) | 23 (6) | 125 (6) | χ2 = 0.01 | 0.94 |
Speech Disorder No. (%) | 46 (13) | 145 (7) | χ2 = 12.30 | 4.54 × 10− 4*** |
Memory Deterioration No. (%) | 32 (9) | 78 (4) | χ2 = 16.86 | < 0.0001**** |
Slow Reaction No. (%) | 22 (6) | 31 (2) | χ2 = 28.67 | < 0.0001**** |
Visual Impairment No. (%) | 20 (5) | 90 (4) | χ2 = 0.73 | 0.39 |
Lethargy No. (%) | 4 (1) | 9 (0) | Z = -1.54 | 0.12 |
Family History of Glioma No. (%) | 1 (0) | 0 (0) | Z = -1.42 | 0.15 |
Respiratory Diseases No. (%) | 0 (0) | 0 (0) | -- | -- |
Digestive Diseases No. (%) | 1 (0) | 0 (0) | Z = -1.45 | 0.15 |
Urinary System Diseases No. (%) | 0 (0) | 2 (0) | Z = 0.00 | 1.00 |
Hematological Disorders No. (%) | 0 (0) | 0 (0) | -- | -- |
Endocrine Diseases No. (%) | 0 (0) | 1 (0) | Z = 0.00 | 1.00 |
Cardiovascular Diseases No. (%) | 1 (0) | 3 (0) | Z = -0.71 | 0.47 |
Previous Surgical History No. (%) | 13 (4) | 21 (1) | χ2 = 13.75 | 2.09 × 10− 4*** |
History of Head Trauma No. (%) | 0 (0) | 6 (0) | Z = -0.53 | 0.60 |
Tumor Location | ||||
Frontal lobe No. (%) | 155 (42) | 1112 (55) | χ2 = 19.71 | < 0.0001**** |
Parietal lobe No. (%) | 55 (15) | 274 (14) | χ2 = 0.58 | 0.45 |
Occipital lobe No. (%) | 38 (10) | 122 (6) | χ2 = 9.40 | 2.17 × 10− 3** |
Temporal lobe No. (%) | 152 (41) | 580 (29) | χ2 = 24.12 | < 0.0001**** |
Insular lobe No. (%) | 23 (6) | 161 (8) | χ2 = 1.22 | 0.27 |
Corpus Callosum No. (%) | 30 (8) | 64 (3) | χ2 = 20.78 | < 0.0001**** |
Thalamus No. (%) | 15 (4) | 31 (2) | χ2 = 10.81 | 1.01 × 10− 3** |
Basal ganglia No. (%) | 6 (2) | 37 (2) | χ2 = 0.06 | 0.80 |
Brainstem No. (%) | 0 (0) | 10 (0) | Z = -0.88 | 0.38 |
Cerebellum No. (%) | 6 (2) | 47 (2) | χ2 = 0.67 | 0.41 |
Ventricle No. (%) | 12 (3) | 61 (3) | χ2 = 0.07 | 0.79 |
Karnofsky Scoreab (%) | 80.98 (14.88), 30.00-100.00 | 84.91 (12.03), 40.00-100.00 | t = 4.77 | < 0.0001**** |
Postoperative Period | ||||
WHO Grade 1/2/3/4 | 1/24/42/300 | 73/896/403/657 | χ2 = 327.14 | < 0.0001**** |
WHO Grade 1 No. (%) | 1 (0) | 73 (4) | χ2 = 11.48 | 7.03 × 10− 4*** |
WHO Grade 2 No. (%) | 24 (7) | 896 (55) | χ2 = 185.95 | < 0.0001**** |
WHO Grade 3 No. (%) | 42 (11) | 403 (20) | χ2 = 14.56 | 1.36 × 10− 4*** |
WHO Grade 4 No. (%) | 300 (82) | 657 (32) | χ2 = 315.70 | < 0.0001**** |
GFAP + a No. (%) | 345 (96) | 1948 (97) | χ2 = 1.47 | 0.23 |
OLIG2 + a No. (%) | 244 (68) | 1593 (80) | χ2 = 25.16 | < 0.0001**** |
P53 + a No. (%) | 197 (55) | 923 (47) | χ2 = 9.20 | 2.43 × 10− 3** |
IDH-1/IDH-2 + a No. (%) | 34 (12) | 798 (49) | χ2 = 129.91 | < 0.0001**** |
Ki-67a ≥ 20% No. (%) | 99 (28) | 294 (15) | χ2 = 36.78 | < 0.0001**** |
TERT + a No. (%) | 79 (54) | 483 (54) | χ2 = 0.01 | 0.91 |
1p/19q Codeletiona No. (%) | 2 (2) | 92 (12) | χ2 = 12.16 | 4.87 × 10− 4*** |
MGMT + a No. (%) | 95 (33) | 638 (42) | χ2 = 8.27 | 4.03 × 10− 3** |
EGFR + a No. (%) | 28 (93) | 84 (73) | χ2 = 5.57 | 0.02* |
Hospitalization Days | 19.58 (10.16), 3.00–99.00 | 18.05 (8.07), 2.00–131.00 | t = -2.70 | 0.01* |
Chemotherapy/Radiotherapy No. (%) | 237 (65) | 1674 (83) | χ2 = 61.86 | < 0.0001**** |
Karnofsky Scoreab (%) | 82.35 (18.93), 30.00-100.00 | 90.63 (12.87), 20.00-100.00 | t = 7.52 | < 0.0001**** |
ECOG Gradea | 1.19 (0.91), 0.00–4.00 | 0.76 (0.70), 0.00–4.00 | t = -7.92 | < 0.0001**** |
Statistical analysis
Results
Characteristics of patients
Logistic regression analysis
Variables | Preoperative Model Odds Ratio (95% CI) | p value | Postoperative Model Odds Ratio (95% CI) | p value |
---|---|---|---|---|
Preoperative Period | ||||
Age (Years at Diagnosis) | 1.06 (1.05, 1.07) | < 0.0001**** | 1.04 (1.02, 1.05) | < 0.0001**** |
Sex male/female | 1.37 (1.06, 1.77) | 0.02* | 1.21 (0.86, 1.71) | 0.27 |
Headache yes/no | 1.56 (1.21, 2.01) | 5.90 × 10− 4*** | 1.46 (1.04, 2.04) | 0.03* |
Vomiting yes/no | 1.45 (0.92, 2.29) | 0.11 | ||
Epilepsy yes/no | 0.64 (0.30, 1.35) | 0.24 | ||
Intracranial Space-Occupying Lesion or Intracranial Tumor yes/no | 0.37 (0.16, 0.87) | 0.02* | ||
Muscle Weakness yes/no | 1.53 (1.12, 2.10) | 0.01* | ||
Speech Disorder yes/no | 1.31 (0.89, 1.92) | 0.18 | ||
Slow Reaction yes/no | 1.92 (1.03, 3.58) | 0.04* | 1.63 (0.68, 3.88) | 0.27 |
Tumor Location (Frontal lobe) yes/no | 0.82 (0.62, 1.09) | 0.18 | ||
Tumor Location (Occipital lobe) yes/no | 1.14 (0.74, 1.77) | 0.55 | ||
Tumor Location (Temporal lobe) yes/no | 1.40 (1.05, 1.86) | 0.02* | 1.51 (1.08, 2.12) | 0.02* |
Tumor Location (Corpus Callosum) yes/no | 2.59 (1.57, 4.26) | 1.85 × 10− 4*** | 2.12 (1.07, 4.20) | 0.03* |
Tumor Location (Thalamus) yes/no | 5.12 (2.53, 10.40) | < 0.0001**** | ||
Karnofsky Score (%) | 0.99 (0.98, 1.00) | 4.76 × 10− 3** | 0.99 (0.98, 1.00) | 0.06 |
Postoperative Period | ||||
WHO Grade 2 yes/no | 0.23 (0.10, 0.51) | 3.19 × 10− 4*** | ||
WHO Grade 4 yes/no | 2.67 (1.67, 4.26) | < 0.0001**** | ||
GFAP + yes/no | 0.29 (0.13, 0.63) | 1.91 × 10− 3** | ||
OLIG2 + yes/no | 0.87 (0.60, 1.27) | 0.47 | ||
IDH-1/IDH-2 + yes/no | 0.41 (0.24, 0.69) | 7.55 × 10− 4*** | ||
Chemotherapy/Radiotherapy yes/no | 0.24 (0.16, 0.37) | < 0.0001**** | ||
Karnofsky Score (%) | 0.98 (0.97, 1.00) | 0.08 | ||
ECOG Grade | 1.09 (0.75, 1.57) | 0.65 |
Combinations of postoperative risk factors
Survival analysis
Variables | WHO Grade 1 and 2 | WHO Grade 3 | WHO Grade 4 | |||
---|---|---|---|---|---|---|
Hazard Ratio (95% CI) | p value | Hazard Ratio (95% CI) | p value | Hazard Ratio (95% CI) | p value | |
Preoperative Period | ||||||
Age (Years at Diagnosis) | 1.02 (1.00, 1.04) | 0.03* | 1.02 (1.01, 1.03) | 3.18 × 10− 3** | 1.01 (1.01, 1.02) | 3.91 × 10− 4*** |
Sex male/female | 1.72 (1.18, 2.52) | 0.01* | 0.99 (0.72, 1.36) | 0.96 | 1.19 (0.99, 1.43) | 0.06 |
Headache yes/no | 1.09 (0.69, 1.71) | 0.72 | 1.24 (0.89, 1.72) | 0.20 | 1.11 (0.93, 1.32) | 0.26 |
Epilepsy yes/no | 0.95 (0.53, 1.69) | 0.86 | 0.93 (0.49, 1.76) | 0.82 | 0.47 (0.15, 1.50) | 0.20 |
Intracranial Space-Occupying Lesion or Intracranial Tumor yes/no | 0.81 (0.39, 1.70) | 0.58 | 0.61 (0.24, 1.52) | 0.29 | 1.34 (0.77, 2.32) | 0.30 |
Illness Duration (Months) | 0.99 (0.97, 1.01) | 0.20 | 0.98 (0.96, 1.00) | 0.10 | 1.00 (0.99, 1.01) | 0.48 |
Tumor Location (Frontal lobe) yes/no | 0.94 (0.62, 1.42) | 0.77 | 0.84 (0.57, 1.22) | 0.35 | 0.91 (0.74, 1.12) | 0.37 |
Tumor Location (Occipital lobe) yes/no | 1.64 (0.48, 5.55) | 0.43 | 1.07 (0.51, 2.23) | 0.86 | 1.18 (0.90, 1.55) | 0.23 |
Tumor Location (Temporal lobe) yes/no | 1.41 (0.91, 2.17) | 0.12 | 1.22 (0.85, 1.74) | 0.28 | 1.15 (0.94, 1.40) | 0.17 |
Karnofsky Score (%) | 0.98 (0.97, 1.00) | 0.03* | 1.00 (0.99, 1.01) | 0.72 | 1.00 (0.99, 1.00) | 0.48 |
Postoperative Period | ||||||
OLIG2 + yes/no | 1.02 (0.58, 1.80) | 0.94 | 0.79 (0.49, 1.28) | 0.34 | 0.78 (0.64, 0.95) | 0.01* |
P53 Gene + yes/no | 2.15 (1.47, 3.13) | < 0.0001**** | 1.96 (1.38, 2.77) | 1.43 × 10− 4*** | 1.22 (1.02, 1.46) | 0.03* |
IDH1/2 + yes/no | 0.51 (0.34, 0.76) | 8.90 × 10− 4*** | 0.45 (0.32, 0.64) | < 0.0001**** | 0.54 (0.39, 0.74) | 1.60 × 10− 4*** |
Chemotherapy/Radiotherapy yes/no | 1.74 (1.00, 3.04) | 0.05 | 0.63 (0.35, 1.13) | 0.12 | 0.38 (0.29, 0.49) | < 0.0001**** |
Karnofsky Score (%) | 0.98 (0.97, 0.99) | 3.50 × 10− 4*** | 0.98 (0.97, 0.99) | 8.75 × 10− 4*** | 0.99 (0.98, 0.99) | < 0.0001**** |