Unplanned 30-Day Readmission in Glioblastoma Patients: Implications for the Extent of Resection and Adjuvant Therapy

SIMPLE SUMMARY: Unplanned early hospital readmission (UER) within 30 days seems to be associated with reduced overall survival in patients diagnosed with glioblastoma (GBM). In this study, we retrospectively analyzed how the extent of tumor resection or adjuvant tumor treatment affected the prognosis in GBM patients that experienced UER. A total of 276 patients were included in the study. UER occurred in 13.4% of all cases and significantly reduced the median survival prognosis (5.7 vs. 14.5 months). Moreover, GBM patients suffering from UER did not benefit from extensive tumor resection (5.1 vs. 5.7 months). Concerning post-operative treatment strategies, the application of radio-chemotherapy prolonged the overall survival of GBM patients, even when UER occurred (1.1 (without post-operative therapy) vs. 4.3 (radiotherapy alone) vs. 7.8 months (radio-chemotherapy)). Therefore, GBM patients experiencing unplanned early readmission within 30 days still benefitted from more aggressive post-operative therapy. ABSTRACT: Background: Unplanned early readmission (UER) within 30 days after hospital release is a negative prognostic marker for patients diagnosed with glioblastoma (GBM). This work analyzes the impact of UER on the effects of standard therapy modalities for GBM patients, including the extent of resection (EOR) and adjuvant therapy regimen. Methods: Records were searched for patients with newly diagnosed GBM between 2014 and 2020 who were treated at our facility. Exclusion criteria were being aged below 18 years or missing data. An overall survival (OS) analysis (Kaplan–Meier estimate; Cox regression) was performed on various GBM patient sub-cohorts. Results: A total of 276 patients were included in the study. UER occurred in 13.4% (n = 37) of all cases, significantly reduced median OS (5.7 vs. 14.5 months, p < 0.001 by logrank), and was associated with an increased hazard of mortality (hazard ratio 3.875, p < 0.001) in multivariate Cox regression when other clinical parameters were applied as confounders. The Kaplan–Meier analysis also showed that patients experiencing UER still benefitted from adjuvant radio-chemotherapy when compared to radiotherapy or no adjuvant therapy (p < 0.001 by logrank). A higher EOR did not improve OS in GBM patients with UER (p = 0.659). Conclusion: UER is negatively associated with survival in GBM patients. In contrast to EOR, adjuvant radio-chemotherapy was beneficial, even after UER.