Objective  This study discusses the prognosis and prognostic factors of postoperative high-grade glioma.

  Methods  Eighty-nine patients with postoperative high-grade glioma were registered at the Jiangxi Province Tumor Hospital between April 2005 and February 2011.Total and partial removal of glioma were performed in 43 and 46 patients, respectively.Based on the World Health Organization(WHO) grading system of glioma, 45 patients in this study had WHO gradeⅢglioma and 44 patients had WHO grade IV glioma.

  Results  The results show that the median survival time of patients with glioma was 13 months.The two-year overall survival rate(OS) was 43.2%, and the two-year progression-free survival rate(PFS) was 36.9%.The prognostic factors of OS identified in univariate analysis include age, pathological grade, and resection extent(P < 0.05).However, the independent prognostic factors in multivariate analysis only include resection extent and age(P < 0.05).The prognostic factors of PFS in univariate analysis include resection extent, postoperative radiotherapy, and ventricle violated before surgery(P < 0.05).However, the independent prognostic factors in multivariate analysis only include resection extent and postoperative radiotherapy(P < 0.05).In this study, tumor recurrence occurred in 41 patients, 65.9% patients had tumor bed failure, and 34.1% had distance failure.Among the 46 patients with damaged ventricles before surgery, 11 displayed distant recurrence.Among the 43 patients who underwent total removal of glioma, 3 had distant metastasis before surgery

  Conclusion  Resection extent and age are the independent prognostic factors of overall survival in glioma, and postoperative radiotherapy can improve the progression-free survival of patients.The major pattern of failure is tumor bed recurrence.However, distance failure increases when the ventricle is damaged.