The impact of midline shift (MLS) on long-term survival and progression in glioblastoma (GBM) is unknown. The objective of this study was to analyze the influence of mass effect on survival and progression with consideration of the patient demographics, tumor morphology, operative techniques, molecular pathology, and postoperative treatment. One hundred ninety-eight patients with GBM were analyzed retrospectively. Both MLS groups (< or ≥ 10 mm) were compared with regard to survival, progression-free survival (PFS), and postoperative course of Karnofsky Performance Status (KPS). A two-sided Fisher exact test showed no statistically significant differences in the confounders between the low- and high-MLS groups. The median survival was 18.0 months (95% confidence interval (CI) = 15.3–20.7) in the low-MLS group (n = 173) and 9.0 months (95% CI = 4.8–13.2) in the high-MLS group (n = 25) (p = 0.045). In the high-MLS group, 59.1% (13/22) with an initially high MLS had a KPS of less than 70% after 3 months, whereas 20.5% of the low-MLS group had a KPS of less than 70% (p < 0.001). Binary logistic regression analysis including the O-6-methylguanine-DNA methyltransferase (MGMT) status, extent of resection, baseline KPS, and MIB-I index showed low MLS as the only predictor for survival at 12 months (p = 0.046, odds ratio (OR) = 2.70, 95% CI = 1.0–7.2). Median PFS was 6.0 months in the high-MLS group and 9.0 months in the low-MLS group (log-rank test; p = 0.08). An initial midline shift of 10 mm or greater seems to be an imaging characteristic that independently predicts the survival in glioblastoma.

中线移位（MLS）对胶质母细胞瘤（GBM）长期存活和进展的影响尚不清楚。这项研究的目的是分析综合效应对生存和进展的影响，并考虑患者的人口统计学，肿瘤形态，手术技术，分子病理学和术后治疗。回顾性分析了198例GBM患者。比较两组MLS（<或≥10 mm）的生存率，无进展生存期（PFS）和卡诺夫斯基机能状态（KPS）的术后病程。双向Fisher精确检验表明，低和高MLS组之间的混杂因素没有统计学上的显着差异。低MLS组中位生存期为18.0个月（95％置信区间（CI）= 15.3–20.7）（n 高MLS组（n  = 25）= 173）和9.0个月（95％CI = 4.8-13.2 ）（p  = 0.045）。在高MLS组中，最初高MLS的59.1％（13/22）在3个月后的KPS低于70％，而低MLS组的20.5％的KPS低于70％（p  <0.001）。二元逻辑回归分析包括O-6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）的状态，切除范围，基线KPS和MIB-1指数显示，低MLS是12个月生存的唯一预测因子​​（p  = 0.046，优势比） （OR）= 2.70，95％CI = 1.0-7.2）。高MLS组的中位PFS为6.0个月，低MLS组的中位PFS为9.0个月（log-rank检验；p = 0.08）。最初的中线偏移为10 mm或更大似乎是独立预测胶质母细胞瘤生存的影像学特征。