Long-Term Outcomes of Neurosurgical Treatment in Glioblastoma Multiforme

This study aimed to evaluate the long-term outcomes of neurosurgical treatment in glioblastoma multiforme (GBM) patients, focusing on the impact of surgical resection type, O6-methylguanine-DNA methyltransferase (MGMT) methylation status, and Karnofsky Performance Status (KPS) on survival.

A retrospective analysis was conducted on 100 GBM patients treated at Mardan Medical Complex, Mardan, Pakistan, between September 2018 and January 2025. The cohort was divided into two groups: long-term survivors (n=50) and short-term survivors (n=50). The study analyzed surgical resection type (gross total resection (GTR), subtotal resection (STR), biopsy), MGMT methylation status, and KPS scores, comparing their associations with survival outcomes.

Results revealed that 56% of patients who underwent GTR survived beyond three years, compared to 24% for STR and 18% for biopsy (p<0.001). Additionally, 48% of patients with MGMT methylation survived long-term, compared to only 12% of those without methylation (p<0.001). A higher KPS score (≥70) was also significantly associated with better survival outcomes (p<0.001). The hazard ratio for GTR vs. STR was 2.5, and for MGMT methylation, it was 3.0.

In conclusion, GTR, MGMT methylation, and a higher KPS score were significant predictors of long-term survival in GBM patients. This study provides valuable insights for optimizing treatment strategies and improving patient outcomes. Future research should focus on larger cohorts and additional genetic markers.