Survival rates in patients with the newly diagnosed glioblastoma: Data from the National Cancer Registry of Ukraine, 2008-2016
Objective. In the current study, we present the results of the survival analysis of patients with newly diagnosed glioblastoma (GBM) in Ukraine.
Materials and methods. A total of 3763 cases of patients with histologically confirmed newly diagnosed GBM who were treated over a 9-year period (2008 – 2016) were included. All patients were grouped as younger adults (<45 years at diagnosis) – 734 (19.5%) cases, middle-aged (45–64 years) – 2360 (62.7%), and older adults (>64 years) – 669 (17.8%). Clinical parameters and survival rates were defined for every three 3-year periods: 2008-2010, 2011-2013, and 2014-2016.
Results. The overall median survival was 12.2±0.2 months. Higher survival rate was observed in young adults 17.4±1.4 months (p<0.001). The hazard ratio (HR) of middle-aged group was 1.79 (95% CI 1.60-2.00; p=0.017) and for older age – 1.51 (95% CI 1.32-1.72; p<0.001). The patients treated in the second period achieved better prognosis with a median survival in 12.6±0.3 months (p<0.001) with HR 0.75, 95% CI 0.66-0.85; p<0.01). The median overall survival in combined treatment protocol group was 16.3±0.5 months, and the worst prognosis was in surgery alone group – 7.5±0.3 months (p<0.001). The HR for surgery with radiotherapy was 1.36 (95% CI 1.22-1.51; p<0.001), and for surgery alone it raised up to 1.94 (95% CI 1.73-2.17; p<0.001). The HR for a combination of surgery with chemotherapy was 1.18 (95% CI 0.90-1.53; p<0.001), but it was not significant (p=0.25).
Conclusions. The using of combined treatment including surgery and chemoradiotherapy was associated with survival advantage for all age groups and time periods.
3. Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014. Neuro Oncol. 2017 Nov 6;19(suppl_5):v1-v88. [CrossRef] [PubMed]
4. Brodbelt A, Greenberg D, Winters T, Williams M, Vernon S, Collins VP; (UK) National Cancer Information Network Brain Tumour Group. Glioblastoma in England: 2007-2011. Eur J Cancer. 2015 Mar;51(4):533-42. [CrossRef] [PubMed]
6. McGirt MJ, Chaichana KL, Gathinji M, Attenello FJ, Than K, Olivi A, Weingart JD, Brem H, Quiсones-Hinojosa AR. Independent association of extent of resection with survival in patients with malignant brain astrocytoma. J Neurosurg. 2009 Jan;110(1):156-62. [CrossRef] [PubMed]
8. Filippini G, Falcone C, Boiardi A, Broggi G, Bruzzone M, Caldiroli D et al. Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma. Neuro-Oncology. 2008;10(1):79-87. [CrossRef] [PubMed]
9. Gil-Robles S, Duffau H. Surgical management of World Health Organization Grade II gliomas in eloquent areas: the necessity of preserving a margin around functional structures. Neurosurgical Focus. 2010;28(2):E8. [CrossRef] [PubMed]
10. Gonzбlez-Darder JM, Gonzбlez-Lуpez P, Talamantes F, Quilis V, Cortйs V, Garcнa-March G, Roldбn P. Multimodal navigation in the functional microsurgical resection of intrinsic brain tumors located in eloquent motor areas: role of tractography. Neurosurg Focus. 2010 Feb;28(2):E5. [CrossRef] [PubMed]
11. Keles G, Lamborn K, Berger M. Low-grade hemispheric gliomas in adults: a critical review of extent of resection as a factor influencing outcome. Journal of Neurosurgery. 2001;95(5):735-745. [CrossRef] [PubMed]
12. Rozumenko VD. Neurooncology: modern state of the problem. Onkologіya. 2006; 8 (2):188-19. Russian. Available from: http://dspace.nbuv.gov.ua/bitstream/handle/123456789/7473/08_561.pdf
13. Rozumenko VD. [Epidemiologiya opukholey golovnogo mozga: statisticheskie faktory]. Ukrainian Neurosurgical Journal. 2002;(3):47-48. Russian. [VernadskyNLU]
14. Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, Lang FF, McCutcheon IE, Hassenbusch SJ, Holland E, Hess K, Michael C, Miller D, Sawaya R. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg. 2001 Aug;95(2):190-8. [CrossRef] [PubMed]
15. Stummer W, Reulen HJ, Meinel T, Pichlmeier U, Schumacher W, Tonn JC, Rohde V, Oppel F, Turowski B, Woiciechowsky C, Franz K, Pietsch T; ALA-Glioma Study Group. Extent of resection and survival in glioblastoma multiforme: identification of and adjustment for bias. Neurosurgery. 2008 Mar;62(3):564-76; discussion 564-76. [CrossRef] [PubMed]
16. Verlut C, Mouillet G, Magnin E, Buffet-Miny J, Viennet G, Cattin F, Billon-Grand NC, Bonnet E, Servagi-Vernat S, Godard J, Billon-Grand R, Petit A, Moulin T, Cals L, Pivot X, Curtit E. Age, Neurological Status MRC Scale, and Postoperative Morbidity are Prognostic Factors in Patients with Glioblastoma Treated by Chemoradiotherapy. Clin Med Insights Oncol. 2016 Aug 17;10:77-82. [CrossRef] [PubMed]
17. Seidlitz A, Siepmann T, Lцck S, Juratli T, Baumann M, Krause M. Impact of waiting time after surgery and overall time of postoperative radiochemotherapy on treatment outcome in glioblastoma multiforme. Radiat Oncol. 2015 Aug 16;10:172. [CrossRef] [PubMed]
18. Kurimoto M, Hayashi N, Kamiyama H, Nagai S, Shibata T, Asahi T, Matsumura N, Hirashima Y, Endo S. Impact of neuronavigation and image-guided extensive resection for adult patients with supratentorial malignant astrocytomas: a single-institution retrospective study. Minim Invasive Neurosurg. 2004 Oct;47(5):278-83. [CrossRef] [PubMed]
19. Rozumenko A, Kliuchka V, Rozumenko V, Semenova V, Kolesnyk S, Fedorenko Z. Image-guided resection of glioblastoma in eloquent brain areas facilitated by laser surface thermal therapy: clinical outcomes and long-term results. Neurosurg Rev. 2018 Jan 22. [CrossRef] [PubMed]
20. Davis FG, Freels S, Grutsch J, Barlas S, Brem S. Survival rates in patients with primary malignant brain tumors stratified by patient age and tumor histological type: an analysis based on Surveillance, Epidemiology, and End Results (SEER) data, 1973-1991. J Neurosurg. 1998 Jan;88(1):1-10. [CrossRef] [PubMed]
21. Li YM, Suki D, Hess K, Sawaya R. The influence of maximum safe resection of glioblastoma on survival in 1229 patients: Can we do better than gross-total resection? J Neurosurg. 2016 Apr;124(4):977-88. [CrossRef] [PubMed]
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