|Paper title||The impact of perioperative adverse events on adjuvant therapy and overall survial in patients with high grade glioma|
|Form of presentation||Poster|
Aims: Maximum safe resection followed by adjuvant chemoradiotherapy is the current standard of care for high grade glioma. The course of the adjuvant therapy can be influenced and impaired by the occurrence of perioperative adverse events (AEs). The aim of this study is to determine the effect of AEs on the timing and the choice of adjuvant treatments as well as on overall survival.
Methods: This is a retrospective analysis of prospectively collected data of 190 adult patients undergoing initial surgery of a high grade glioma at the University Hospital Zürich between 2013 and 2015. Assessed parameters were: basic patients characteristics, functional status (KPS), extent of resection, tumor grade, AEs (Clavien-Dindo classification), modality and timing of adjuvant treatment (including delay, interruption or non-initiation) and overall survival.
Results: In 75 (39%) of the cases an AE occurred in the time period from admission to 3 months postOP. There was a significant association of AEs with an increased waiting time for adjuvant therapy (p = 0.002), a higher rate of interruption (p < 0.001) and non-initiation (p < 0.001). Higher CDG grades correlated with an increased waiting time (p = 0.029). Interrupted adjuvant therapy (p < 0.001) or non-initiation of adjuvant therapy (p < 0.001) were individually associated with a significant decrease in overall survival. However, the occurrence of AEs was not found to be an independent predictor of overall survival in a multivariate model.
Conclusion: Perioperative AEs have a significant impact on the timing and the modality of adjuvant therapy and might consequentially lead to decreased survival. This works emphasizes the importance of prevention and treatment of AEs and quantifies the impact of AEs on adjuvant therapy and patient outcome.