Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Short-course high-dose methylprednisolone reduces complications and shortens hospital stay after glioblastoma resection: a propensity score-matched cohort study.
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Lin Jinfeng, Li Kaichen, Chen Zhuoyang, Ye Zhi, Zhang Huayang, Tang Woheng, Li Zhiyong, Qu Shanqiang, Yi Guo-Zhong, Huang Guanglong
Аннотация
BACKGROUND: Perioperative corticosteroid use for patients with isocitrate dehydrogenase (IDH)-wildtype glioblastoma (GBM) after surgical resection remains unstandardized, and conventional dexamethasone regimens are linked to elevated venous thromboembolism risk and adverse survival impacts. This study aimed to evaluate the effects of short-course high-dose methylprednisolone (MP) on length of hospital stay (LOS), postoperative complications, and long-term outcomes in patients with IDH-wildtype GBM.
METHODS: This study included 315 adult patients with newly diagnosed IDH-wildtype GBM who underwent surgery at Nanfang Hospital between January 2019 and June 2024. Patients were assigned to the MP group (intravenous MP 500 mg/day within the first three postoperative days) or the non-MP group (no MP administered during this window). 1:1 propensity score matching (PSM) was performed to balance baseline clinical and tumor-related covariates. Primary outcomes were LOS and 30-day postoperative complications; secondary outcomes included progression-free survival (PFS), overall survival (OS), and dynamic changes of perioperative inflammatory-immune biomarkers.
RESULTS: 232 patients were included in the final matched cohort (116 per group). The MP group had a significantly shorter median LOS (11.0 vs 12.5 days, P < 0.001) and lower incidence of deep vein thrombosis (DVT) (0% vs 6.03%, P = 0.014) compared with the non-MP group. Multivariate analysis confirmed MP administration was an independent protective factor for shortened LOS (incidence rate ratio = 0.916, 95% CI: 0.851-0.986, P = 0.019) and reduced DVT risk (odds ratio = 0.063, 95% CI: 0.000-0.524, P = 0.006). No significant between-group differences were observed in PFS (P = 0.938) or OS (P = 0.948). MP significantly modulated early postoperative inflammatory biomarkers without sustained immune disturbance.
CONCLUSION: Short-course high-dose MP after GBM resection was significantly associated with reducing LOS and postoperative DVT incidence, without increasing steroid-related complications or impairing long-term survival. This regimen provides a feasible alternative for postoperative corticosteroid use in GBM patients.
METHODS: This study included 315 adult patients with newly diagnosed IDH-wildtype GBM who underwent surgery at Nanfang Hospital between January 2019 and June 2024. Patients were assigned to the MP group (intravenous MP 500 mg/day within the first three postoperative days) or the non-MP group (no MP administered during this window). 1:1 propensity score matching (PSM) was performed to balance baseline clinical and tumor-related covariates. Primary outcomes were LOS and 30-day postoperative complications; secondary outcomes included progression-free survival (PFS), overall survival (OS), and dynamic changes of perioperative inflammatory-immune biomarkers.
RESULTS: 232 patients were included in the final matched cohort (116 per group). The MP group had a significantly shorter median LOS (11.0 vs 12.5 days, P < 0.001) and lower incidence of deep vein thrombosis (DVT) (0% vs 6.03%, P = 0.014) compared with the non-MP group. Multivariate analysis confirmed MP administration was an independent protective factor for shortened LOS (incidence rate ratio = 0.916, 95% CI: 0.851-0.986, P = 0.019) and reduced DVT risk (odds ratio = 0.063, 95% CI: 0.000-0.524, P = 0.006). No significant between-group differences were observed in PFS (P = 0.938) or OS (P = 0.948). MP significantly modulated early postoperative inflammatory biomarkers without sustained immune disturbance.
CONCLUSION: Short-course high-dose MP after GBM resection was significantly associated with reducing LOS and postoperative DVT incidence, without increasing steroid-related complications or impairing long-term survival. This regimen provides a feasible alternative for postoperative corticosteroid use in GBM patients.