Abstract

Background: Clinical and molecular factors are essential to define the prognosis in patients with glioblastoma (GBM). O6-methylguanine-DNA methyltransferase (MGMT) methylation status, age, Karnofsky Performance Status (KPS), and extent of surgical resection are the most relevant prognostic factors. Our investigation of the role of gender in predicting prognosis shows a slight survival advantage for female patients. Methods: We performed a prospective evaluation of the Project of Emilia Romagna on Neuro-Oncology (PERNO) registry to identify prognostic factors in patients with GBM who received standard treatment. Results: A total of 169 patients (99 males [58.6%] and 70 females [41.4%]) were evaluated prospectively. MGMT methylation was evaluable in 140 patients. Among the male patients, 36 were MGMT methylated (25.7%) and 47 were unmethylated (33.6%); among the female patients, 32 were methylated (22.9%) and 25 were unmethylated (17.9%). Survival was longer in the methylated females compared with the methylated males (P = 0.028) but was not significantly different between the unmethylated females and the unmethylated males (P = 0.395). In multivariate analysis, gender and MGMT methylation status considered together (methylated females vs. methylated males; hazard ratio [HR], 0.459; 95% confidence interval [CI], 0.242–0.827; P = 0.017), age (HR, 1.025; 95% CI, 1.002–1.049; P = 0.032), and KPS (HR, 0.965; 95% CI, 0.948–0.982; P < 0.001) were significantly correlated with survival. Conclusions: Survival was consistently longer among MGMT methylated females compared with males. Gender can be considered as a further prognostic factor.

Original languageEnglish
Pages (from-to)e342-e347
JournalWorld Neurosurgery
Volume112
DOIs
Publication statusPublished - Apr 1 2018

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Methyltransferases
DNA Methylation
Glioblastoma
Karnofsky Performance Status
Survival
Confidence Intervals
DNA
O-(6)-methylguanine
Power (Psychology)
Registries
Multivariate Analysis

Keywords

  • Gender
  • Glioblastoma
  • Methylation
  • MGMT
  • PERNO

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

The Prognostic Roles of Gender and O6-Methylguanine-DNA Methyltransferase Methylation Status in Glioblastoma Patients : The Female Power. / PERNO Study Group.

In: World Neurosurgery, Vol. 112, 01.04.2018, p. e342-e347.

Research output: Contribution to journalArticle

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title = "The Prognostic Roles of Gender and O6-Methylguanine-DNA Methyltransferase Methylation Status in Glioblastoma Patients: The Female Power",
abstract = "Background: Clinical and molecular factors are essential to define the prognosis in patients with glioblastoma (GBM). O6-methylguanine-DNA methyltransferase (MGMT) methylation status, age, Karnofsky Performance Status (KPS), and extent of surgical resection are the most relevant prognostic factors. Our investigation of the role of gender in predicting prognosis shows a slight survival advantage for female patients. Methods: We performed a prospective evaluation of the Project of Emilia Romagna on Neuro-Oncology (PERNO) registry to identify prognostic factors in patients with GBM who received standard treatment. Results: A total of 169 patients (99 males [58.6{\%}] and 70 females [41.4{\%}]) were evaluated prospectively. MGMT methylation was evaluable in 140 patients. Among the male patients, 36 were MGMT methylated (25.7{\%}) and 47 were unmethylated (33.6{\%}); among the female patients, 32 were methylated (22.9{\%}) and 25 were unmethylated (17.9{\%}). Survival was longer in the methylated females compared with the methylated males (P = 0.028) but was not significantly different between the unmethylated females and the unmethylated males (P = 0.395). In multivariate analysis, gender and MGMT methylation status considered together (methylated females vs. methylated males; hazard ratio [HR], 0.459; 95{\%} confidence interval [CI], 0.242–0.827; P = 0.017), age (HR, 1.025; 95{\%} CI, 1.002–1.049; P = 0.032), and KPS (HR, 0.965; 95{\%} CI, 0.948–0.982; P < 0.001) were significantly correlated with survival. Conclusions: Survival was consistently longer among MGMT methylated females compared with males. Gender can be considered as a further prognostic factor.",
keywords = "Gender, Glioblastoma, Methylation, MGMT, PERNO",
author = "{PERNO Study Group} and Enrico Franceschi and A. Tosoni and Santino Minichillo and Roberta Depenni and Alexandro Paccapelo and Francesca Zanelli and Antonio Fioravanti and Agostino Baruzzi and Agostino Baruzzi and Agostino Baruzzi and F. Albani and R. D'Alessandro and R. Michelucci and M. Cavallo and A. Tosoni and A. Valentini and A. Pisanello and S. Testoni and R. Agati and A. Bacci and E. Baldin and E. Barbieri and F. Bisulli and V. Carelli and M. Crisci and {de Biase}, D. and C. Franceschi and M. Leonardi and G. Marucci and L. Morandi and B. Mostacci and G. Palandri and E. Pasini and P. Riguzzi and P. Tinuper and M. Dall'Agata and G. Gentili and M. Faedi and F. Zumaglini and A. Amadori and F. Bertolini and G. Pinna and M. Costa and M. Ragazzi and R. Rizzi and S. Seraceni and C. Giorgi and E. Montanari and S. Mazza and F. Servadei",
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month = "4",
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TY - JOUR

T1 - The Prognostic Roles of Gender and O6-Methylguanine-DNA Methyltransferase Methylation Status in Glioblastoma Patients

T2 - The Female Power

AU - PERNO Study Group

AU - Franceschi, Enrico

AU - Tosoni, A.

AU - Minichillo, Santino

AU - Depenni, Roberta

AU - Paccapelo, Alexandro

AU - Zanelli, Francesca

AU - Fioravanti, Antonio

AU - Baruzzi, Agostino

AU - Baruzzi, Agostino

AU - Baruzzi, Agostino

AU - Albani, F.

AU - D'Alessandro, R.

AU - Michelucci, R.

AU - Cavallo, M.

AU - Tosoni, A.

AU - Valentini, A.

AU - Pisanello, A.

AU - Testoni, S.

AU - Agati, R.

AU - Bacci, A.

AU - Baldin, E.

AU - Barbieri, E.

AU - Bisulli, F.

AU - Carelli, V.

AU - Crisci, M.

AU - de Biase, D.

AU - Franceschi, C.

AU - Leonardi, M.

AU - Marucci, G.

AU - Morandi, L.

AU - Mostacci, B.

AU - Palandri, G.

AU - Pasini, E.

AU - Riguzzi, P.

AU - Tinuper, P.

AU - Dall'Agata, M.

AU - Gentili, G.

AU - Faedi, M.

AU - Zumaglini, F.

AU - Amadori, A.

AU - Bertolini, F.

AU - Pinna, G.

AU - Costa, M.

AU - Ragazzi, M.

AU - Rizzi, R.

AU - Seraceni, S.

AU - Giorgi, C.

AU - Montanari, E.

AU - Mazza, S.

AU - Servadei, F.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background: Clinical and molecular factors are essential to define the prognosis in patients with glioblastoma (GBM). O6-methylguanine-DNA methyltransferase (MGMT) methylation status, age, Karnofsky Performance Status (KPS), and extent of surgical resection are the most relevant prognostic factors. Our investigation of the role of gender in predicting prognosis shows a slight survival advantage for female patients. Methods: We performed a prospective evaluation of the Project of Emilia Romagna on Neuro-Oncology (PERNO) registry to identify prognostic factors in patients with GBM who received standard treatment. Results: A total of 169 patients (99 males [58.6%] and 70 females [41.4%]) were evaluated prospectively. MGMT methylation was evaluable in 140 patients. Among the male patients, 36 were MGMT methylated (25.7%) and 47 were unmethylated (33.6%); among the female patients, 32 were methylated (22.9%) and 25 were unmethylated (17.9%). Survival was longer in the methylated females compared with the methylated males (P = 0.028) but was not significantly different between the unmethylated females and the unmethylated males (P = 0.395). In multivariate analysis, gender and MGMT methylation status considered together (methylated females vs. methylated males; hazard ratio [HR], 0.459; 95% confidence interval [CI], 0.242–0.827; P = 0.017), age (HR, 1.025; 95% CI, 1.002–1.049; P = 0.032), and KPS (HR, 0.965; 95% CI, 0.948–0.982; P < 0.001) were significantly correlated with survival. Conclusions: Survival was consistently longer among MGMT methylated females compared with males. Gender can be considered as a further prognostic factor.

AB - Background: Clinical and molecular factors are essential to define the prognosis in patients with glioblastoma (GBM). O6-methylguanine-DNA methyltransferase (MGMT) methylation status, age, Karnofsky Performance Status (KPS), and extent of surgical resection are the most relevant prognostic factors. Our investigation of the role of gender in predicting prognosis shows a slight survival advantage for female patients. Methods: We performed a prospective evaluation of the Project of Emilia Romagna on Neuro-Oncology (PERNO) registry to identify prognostic factors in patients with GBM who received standard treatment. Results: A total of 169 patients (99 males [58.6%] and 70 females [41.4%]) were evaluated prospectively. MGMT methylation was evaluable in 140 patients. Among the male patients, 36 were MGMT methylated (25.7%) and 47 were unmethylated (33.6%); among the female patients, 32 were methylated (22.9%) and 25 were unmethylated (17.9%). Survival was longer in the methylated females compared with the methylated males (P = 0.028) but was not significantly different between the unmethylated females and the unmethylated males (P = 0.395). In multivariate analysis, gender and MGMT methylation status considered together (methylated females vs. methylated males; hazard ratio [HR], 0.459; 95% confidence interval [CI], 0.242–0.827; P = 0.017), age (HR, 1.025; 95% CI, 1.002–1.049; P = 0.032), and KPS (HR, 0.965; 95% CI, 0.948–0.982; P < 0.001) were significantly correlated with survival. Conclusions: Survival was consistently longer among MGMT methylated females compared with males. Gender can be considered as a further prognostic factor.

KW - Gender

KW - Glioblastoma

KW - Methylation

KW - MGMT

KW - PERNO

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DO - 10.1016/j.wneu.2018.01.045

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