Abstract:
BACKGROUND:It is a prevalent myth that a postoperative infection may actually confer a survival advantage in patients with malignant glioma. This contention is based largely on anecdotal reports. Recently, a single-center study showed there was no survival advantage in those patients who had glioblastoma with postoperative infection. OBJECTIVE:To examine the impact of postoperative infections on outcome in patients with glioblastoma treated at our center. METHODS:This study included 197 patients with newly diagnosed primary glioblastoma treated from January 2001 to January 2008. Of the 197 patients, 10 (5.08%) had postoperative bacterial infection. The Kaplan-Meier method, log-rank test, and Breslow test were used in the univariate approach; Cox regression was used in the multivariable approach. RESULTS:The median survival was 16 months (95% confidence interval [CI], 14-18 mo). The infection group had a significant advantage in the median survival: 30 months (95% CI, 21-39) vs 15 months (95% CI, 13-17) for patients without postoperative infection. This advantage was also confirmed by Cox regression; in fact, patients not developing a postoperative infection showed an adjusted hazard ratio for death of 2.3 (95% CI, 1-5.3). CONCLUSION:The association between infection and prolonged survival is not definitive; we acknowledge the considerable difficulties in undertaking this type of study in a retrospective manner. Our results can instead stimulate further multicentric studies (to increase the number of patients) or experimental studies using genetically modified bacteria for treatment of glioblastoma.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
De Bonis P,Albanese A,Lofrese G,de Waure C,Mangiola A,Pettorini BL,Pompucci A,Balducci M,Fiorentino A,Lauriola L,Anile C,Maira Gdoi
10.1227/NEU.0b013e318222adfasubject
Has Abstractpub_date
2011-10-01 00:00:00pages
864-8; discussion 868-9issue
4eissn
0148-396Xissn
1524-4040pii
00006123-201110000-00024journal_volume
69pub_type
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