Objectives This study aims to investigate the prognostic value of Temporal Muscle Thickness (TMT) in Chinese patients with newly diagnosed isocitrate dehydrogenase (IDH) wild-type glioblastoma. Methods Data were retrospectively collected from patients with isocitrate dehydrogenase wild-type genotype glioblastoma, who underwent surgical treatment and concurrent chemoradiotherapy at our center between May 2019 and May 2023. Multi-model and multivariate Cox regression were used to examine factors associated with overall and progression-free survival. Subgroup analysis and sensitivity tests were performed to verify the robustness of the results. Restricted cubic spline regression was used to explore the possible nonlinear relationship between TMT and OS/PFS. Results A total of 344 patients were enrolled in this study. The main analysis showed that TMT was positively correlated with overall survival and progression-free survival. The results of multivariate Cox regression after segmentation according to the optimal cutoff value showed that age ≥ 60 years (HR = 1.47, 95% CI: 1.14–1.90, p = 0.003), diabetes (HR = 1.95, 95% CI: 1.26–3.04, p = 0.003) were the risk factors for death. However, TMT ≥ 8.425 mm (HR = 0.45, 95% CI: 0.36–0.57, p < 0.001), Karnofsky ≥ 70 (HR = 0.76, 95% CI: 0.59–0.97, p < 0.031) were associated with a lower risk of death. Age ≥ 60 years (HR = 1.33, 95% CI: 1.03–1.71, p = 0.028) was a risk factor for recurrence, Karnofsky ≥ 70 (HR = 0.76, 95% CI: 0.59–0.97, p = 0.027), TMT ≥ 8.4 mm (HR = 0.64, 95% CI: 0.50–0.80, p < 0.001), and combination of targeted therapy (HR = 0.65, 95% CI: 0.47–0.90, p = 0.01) reduced recurrence risk. Conclusion TMT is an independent predictor of OS and PFS in IDH wild-type GBM patients and can be used to predict prognosis in clinical practice. Key Points <Emphasis Type="BoldItalic">Question</Emphasis> Performance status of glioblastoma patients is crucial for treatment decision-making and prognosis assessment; however, there is currently no objective evaluation metric for the Chinese population. <Emphasis Type="BoldItalic">Findings</Emphasis> Temporal muscle thickness at initial diagnosis is positively correlated with overall survival and progression-free survival in Chinese patients with newly diagnosed IDH wild-type glioblastoma. <Emphasis Type="BoldItalic">Clinical relevance</Emphasis> Temporal muscle thickness at initial diagnosis is an independent, objective prognostic factor for newly diagnosed IDH wild-type glioblastoma patients in China. It contributes to the formulation of individualized treatment plans and serves as a stratification factor in clinical trials.

Predictive value of temporal muscle thickness for prognosis in newly diagnosed IDH wild-type glioblastoma patients: evaluated for a Chinese population

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发表日期：

2025年1月31日

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Boya Zha,
Yajing Ma,
Boqun Zha,
Xinbin Guo

摘要

Objectives

This study aims to investigate the prognostic value of Temporal Muscle Thickness (TMT) in Chinese patients with newly diagnosed isocitrate dehydrogenase (IDH) wild-type glioblastoma.

Methods

Data were retrospectively collected from patients with isocitrate dehydrogenase wild-type genotype glioblastoma, who underwent surgical treatment and concurrent chemoradiotherapy at our center between May 2019 and May 2023. Multi-model and multivariate Cox regression were used to examine factors associated with overall and progression-free survival. Subgroup analysis and sensitivity tests were performed to verify the robustness of the results. Restricted cubic spline regression was used to explore the possible nonlinear relationship between TMT and OS/PFS.

Results

A total of 344 patients were enrolled in this study. The main analysis showed that TMT was positively correlated with overall survival and progression-free survival. The results of multivariate Cox regression after segmentation according to the optimal cutoff value showed that age ≥ 60 years (HR = 1.47, 95% CI: 1.14–1.90, p = 0.003), diabetes (HR = 1.95, 95% CI: 1.26–3.04, p = 0.003) were the risk factors for death. However, TMT ≥ 8.425 mm (HR = 0.45, 95% CI: 0.36–0.57, p < 0.001), Karnofsky ≥ 70 (HR = 0.76, 95% CI: 0.59–0.97, p < 0.031) were associated with a lower risk of death. Age ≥ 60 years (HR = 1.33, 95% CI: 1.03–1.71, p = 0.028) was a risk factor for recurrence, Karnofsky ≥ 70 (HR = 0.76, 95% CI: 0.59–0.97, p = 0.027), TMT ≥ 8.4 mm (HR = 0.64, 95% CI: 0.50–0.80, p < 0.001), and combination of targeted therapy (HR = 0.65, 95% CI: 0.47–0.90, p = 0.01) reduced recurrence risk.

Conclusion

TMT is an independent predictor of OS and PFS in IDH wild-type GBM patients and can be used to predict prognosis in clinical practice.

Key Points

Question Performance status of glioblastoma patients is crucial for treatment decision-making and prognosis assessment; however, there is currently no objective evaluation metric for the Chinese population.

Findings Temporal muscle thickness at initial diagnosis is positively correlated with overall survival and progression-free survival in Chinese patients with newly diagnosed IDH wild-type glioblastoma.

Clinical relevance Temporal muscle thickness at initial diagnosis is an independent, objective prognostic factor for newly diagnosed IDH wild-type glioblastoma patients in China. It contributes to the formulation of individualized treatment plans and serves as a stratification factor in clinical trials.