Postoperative infection may influence survival in patients with glioblastoma: Simply a myth?

Pasquale De Bonis, Alessio Albanese, Giorgio Lofrese, Chiara De Waure, Annunziato Mangiola, Benedetta Ludovica Pettorini, Angelo Pompucci, Mario Balducci, Alba Fiorentino, Libero Lauriola, Carmelo Anile, Giulio Maira

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)864-868
Number of pages5
JournalNeurosurgery
Volume69
Issue number4
DOIs
Publication statusPublished - Oct 2011

Fingerprint

Glioblastoma
Survival
Infection
Confidence Intervals
Bacterial Infections
Glioma
Bacteria

Keywords

  • Glioblastoma
  • Infection
  • Outcome
  • Surgical infection
  • Survival

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

De Bonis, P., Albanese, A., Lofrese, G., De Waure, C., Mangiola, A., Pettorini, B. L., ... Maira, G. (2011). Postoperative infection may influence survival in patients with glioblastoma: Simply a myth? Neurosurgery, 69(4), 864-868. https://doi.org/10.1227/NEU.0b013e318222adfa

Postoperative infection may influence survival in patients with glioblastoma : Simply a myth? / De Bonis, Pasquale; Albanese, Alessio; Lofrese, Giorgio; De Waure, Chiara; Mangiola, Annunziato; Pettorini, Benedetta Ludovica; Pompucci, Angelo; Balducci, Mario; Fiorentino, Alba; Lauriola, Libero; Anile, Carmelo; Maira, Giulio.

In: Neurosurgery, Vol. 69, No. 4, 10.2011, p. 864-868.

Research output: Contribution to journalArticle

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, G 2011, 'Postoperative infection may influence survival in patients with glioblastoma: Simply a myth?', Neurosurgery, vol. 69, no. 4, pp. 864-868. https://doi.org/10.1227/NEU.0b013e318222adfa
De Bonis P, Albanese A, Lofrese G, De Waure C, Mangiola A, Pettorini BL et al. Postoperative infection may influence survival in patients with glioblastoma: Simply a myth? Neurosurgery. 2011 Oct;69(4):864-868. https://doi.org/10.1227/NEU.0b013e318222adfa
De Bonis, Pasquale ; Albanese, Alessio ; Lofrese, Giorgio ; De Waure, Chiara ; Mangiola, Annunziato ; Pettorini, Benedetta Ludovica ; Pompucci, Angelo ; Balducci, Mario ; Fiorentino, Alba ; Lauriola, Libero ; Anile, Carmelo ; Maira, Giulio. / Postoperative infection may influence survival in patients with glioblastoma : Simply a myth?. In: Neurosurgery. 2011 ; Vol. 69, No. 4. pp. 864-868.
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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.",
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AU - Pompucci, Angelo

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