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What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome

BACKGROUND: Glioblastoma is the most common and most aggressive primary brain tumor in adults. Despite multimodal treatment, the median survival time is 15–16 months and 5-year survival rate 5%–10%. The primary goal of this study was to identify prognostic factors for survival in an unselected popul...

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Autores principales: Fekete, B., Werlenius, K., Tisell, M., Pivodic, A., Smits, A., Jakola, A. S., Rydenhag, B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498299/
https://www.ncbi.nlm.nih.gov/pubmed/37711136
http://dx.doi.org/10.3389/fsurg.2023.1249366
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author Fekete, B.
Werlenius, K.
Tisell, M.
Pivodic, A.
Smits, A.
Jakola, A. S.
Rydenhag, B.
author_facet Fekete, B.
Werlenius, K.
Tisell, M.
Pivodic, A.
Smits, A.
Jakola, A. S.
Rydenhag, B.
author_sort Fekete, B.
collection PubMed
description BACKGROUND: Glioblastoma is the most common and most aggressive primary brain tumor in adults. Despite multimodal treatment, the median survival time is 15–16 months and 5-year survival rate 5%–10%. The primary goal of this study was to identify prognostic factors for survival in an unselected population of patients operated for glioblastoma. The secondary goal was to explore changes in outcome and the clinical management of this patient group over time. METHODS: We identified 222 consecutive adults operated for glioblastoma between November 2012 and June 2016 at the Department of Neurosurgery, Sahlgrenska University Hospital in Gothenburg, serving a health care region in the western part of Sweden with 1.900.000 inhabitants. Clinical variables were identified and tested as predictors for prognosis in extended Poisson regression models. The results were compared with a previously published cohort from 2004 to 2008, before current standard of care based on molecular tumor diagnosis was fully implemented. RESULTS: Median overall survival was 1.07 years, which was significantly longer than in the 2004–2008 cohort (1.07 vs. 0.73 y, age- and sex adjusted HR = 1.89, p < 0.0001). Variables associated with longer survival in the multivariable model were MGMT promoter hypermethylation, non-central tumor location, complete resection of enhancing tumor, WHO performance status 0–1, unilateral tumor location, fewer lobes involved, younger age and no comorbidities. CONCLUSION: The median survival for patients with glioblastoma treated according to current standard treatment has moderately but significantly increased, with MGMT promoter hypermethylation as the strongest predictor for survival.
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spelling pubmed-104982992023-09-14 What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome Fekete, B. Werlenius, K. Tisell, M. Pivodic, A. Smits, A. Jakola, A. S. Rydenhag, B. Front Surg Surgery BACKGROUND: Glioblastoma is the most common and most aggressive primary brain tumor in adults. Despite multimodal treatment, the median survival time is 15–16 months and 5-year survival rate 5%–10%. The primary goal of this study was to identify prognostic factors for survival in an unselected population of patients operated for glioblastoma. The secondary goal was to explore changes in outcome and the clinical management of this patient group over time. METHODS: We identified 222 consecutive adults operated for glioblastoma between November 2012 and June 2016 at the Department of Neurosurgery, Sahlgrenska University Hospital in Gothenburg, serving a health care region in the western part of Sweden with 1.900.000 inhabitants. Clinical variables were identified and tested as predictors for prognosis in extended Poisson regression models. The results were compared with a previously published cohort from 2004 to 2008, before current standard of care based on molecular tumor diagnosis was fully implemented. RESULTS: Median overall survival was 1.07 years, which was significantly longer than in the 2004–2008 cohort (1.07 vs. 0.73 y, age- and sex adjusted HR = 1.89, p < 0.0001). Variables associated with longer survival in the multivariable model were MGMT promoter hypermethylation, non-central tumor location, complete resection of enhancing tumor, WHO performance status 0–1, unilateral tumor location, fewer lobes involved, younger age and no comorbidities. CONCLUSION: The median survival for patients with glioblastoma treated according to current standard treatment has moderately but significantly increased, with MGMT promoter hypermethylation as the strongest predictor for survival. Frontiers Media S.A. 2023-08-30 /pmc/articles/PMC10498299/ /pubmed/37711136 http://dx.doi.org/10.3389/fsurg.2023.1249366 Text en © 2023 Fekete, Werlenius, Tisell, Pivodic, Smits, Jakola and Rydenhag. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Fekete, B.
Werlenius, K.
Tisell, M.
Pivodic, A.
Smits, A.
Jakola, A. S.
Rydenhag, B.
What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome
title What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome
title_full What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome
title_fullStr What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome
title_full_unstemmed What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome
title_short What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome
title_sort what predicts survival in glioblastoma? a population-based study of changes in clinical management and outcome
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498299/
https://www.ncbi.nlm.nih.gov/pubmed/37711136
http://dx.doi.org/10.3389/fsurg.2023.1249366
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