# Long-Term Outcomes of Neurosurgical Treatment in Glioblastoma Multiforme

## TL;DR

This study finds that complete tumor removal, MGMT methylation, and better patient health are linked to longer survival in glioblastoma patients.

## Contribution

The study identifies key predictors of long-term survival in GBM patients through a retrospective analysis of surgical and clinical factors.

## Key findings

- 56% of patients who underwent gross total resection survived beyond three years.
- MGMT methylation was associated with 48% long-term survival compared to 12% without methylation.
- Higher KPS scores (≥70) were significantly linked to better survival outcomes.

## Abstract

Objective: 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.

Methodology: 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: 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.

Conclusion: 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.