Quality Of Life And Survival Analysis In The Postoperative Patients With Glioma

Glioma is the most familiar disease of encephalic tumors. The incidence rate of encephalic tumors is 32 /100000, of which glioma occupy 35.26% to 60.96% (the median is 44.69%). These diseases are more likely developed in the persons who are 20 to 50 years old. The prognosis of most malignant gliomas is worse. The mean survival time of low malignacy tumor patients are 3 to 5 years, and the high malignancy primary tumor patients are 1 to 2 years. The tumors seriously influence the health of humanity.During the surgery and radio or chemical therapy, patients would feel great distress and their families have to afford huge economic expends. Possible permanent disability and deprivation of labor due to the tumors or surgery therapy would seriously reduce the life quality of patients and their families, and it may lead to some social problems. So it is very important to take preventive measures to reduce the incidence of glioma exclude dedicating to the improvement of diagnosis and therapy of the tumors. At present, many advanced techniques of diagnosis and treatment have been applied to clinic and have gotten sound effects, but its long-term effects are still not satisfactory. The synthetic cure giving prioty to operation is yet the fundamental principle followed in cure of glioma.Qualit of life (QOF) as a scale reflecting the patients' healthy situation can be counted on to appraise the effects of cure objectively and fully. The research applies statistiacl analysis to identify prognostic fators for survival and appraise the curative effects of operation in patients with giloma after surgery. This is a problem to be settled urgently. Hence the research has important significance in theory and parctical vuale in use.The research subjects consisted of 522 patients who were operated at QiluHospital of Shandong University between 2000 and 2006. The data were gotten by case recorder and follow-up which is between 12 to 72 months. On the basis of satsitical description, we select 17 related factors for analyzing which include age, sex, occupation, educational background, tumour location, Kfs score before surgery, pathological grades, epilepsy seizure before surgery, extent of resection in surgery, bleeding in surgery, blood transfusion, operation time, complications, epilepsy seizure after surgery, chemotherapy after surgery, radiotherapy after surgery, cost pay method. For the univariate analysis, we use t test, x~2 test, Wilcoxon test, Kruskal-Wallis test. Kaplan-Meier's Product-Limit Survival Estimates method and Log-rank test. Multivariate regression analysis uses Logistic proportional-hazards model and COX proportional-hazards model.The main results of the study are as follwos.1. The factors affecting the quality of life.(1) Univariate analysis(α=0.05):1 month: age, pathological grades, extent of resection in surgery, bleeding in surgery,blood transfusion3 months: age, pathological grades, bleeding in surgery, blood transfusion1 year: age, pathological grades, extent of resection in surgery, bleeding in surgery3 years: age, pathological grades5 years: age, sex, pathological grades, extent of resection in surgery(2) Multivariate analysis(a=0.05):1 month: age, pathological grades, bleeding in surgery3 months: age, pathological grades, bleeding in surgery1 year: age, pathological grades, bleeding in surgery3 years: age, pathological grades, bleeding in surgery5 years: age, pathological grades, extent of resection in surgery2. The factors affecting the survival of postoperation:(1) In Univariate analysis, the statistic significance was observed in patient age, sex, extent of resection in surgery, pathological grades.(2) While Multivariate survival analysis showed that patient age, extent of resection insurgery, pathological grades, chemotherapy after surgery were independentstatistically significant prognostic factors.Conclusion:1. The main factors that affecting the quality of life in patients with glioma is age, pathological grades and bleeding in surgery.2. Age, extent of resection in surgery, pathological grades, chemotherapy after surgery, radiotherapy after surgery and cost pay method are the main factors that affecting the survival of postoperation in patients with glioma; while sex, educational background, occupation, bleeding in surgery, blood transfusion, tumour location, KFS score before surgery, pathological grades, epilepsy seizure before surgery, operation time, complications and epilepsy seizure after surgery have no significant correlation with survival.