The online version of this article (doi:10.1186/1477-7819-10-75) contains supplementary material, which is available to authorized users.
The authors of this manuscript have no conflicts of interests, ethical conflicts or financial disclosures to make regarding this paper.
SRT and CML reviewed relevant literature and drafted the manuscript. BJP conducted all statistical analyses. RKF, WTL, ARM, JJD, BSC, ALE and PWH provided clinical expertise and participated in drafting the manuscript. All authors read and approved the final manuscript.
Glioblastoma Multiforme (GBM) is one of the most aggressive primary brain tumors and is associated with a dismal prognosis. The median survival after the primary diagnosis remains poor, even after multimodal treatment approaches. However, a few patients have been reported to have long term survival greater than three years. A number of studies have attempted to define factors capable of predicting long term outcomes in specific patient groups. This article reports the outcomes of a very large group of patients diagnosed with GBM, and analyzes specific prognostic factors known to influence survival in these patients.
We used the Surveillance, Epidemiology, and End Results (SEER) database of the US National Cancer Institute (NCI) to investigate various patient-related and treatment- related factors that could influence the long term survival in patients diagnosed with glioblastoma. A total of 34,664 patients aged 20 years or older with a diagnosis of GBM during the years 1973 to 2008 were studied. Overall survival outcomes were examined with Kaplan-Meier survival analysis and Cox hazard models.
Asian/Pacific Islanders had a better survival compared to the white population (P = <0.001). Patients diagnosed with GBM during the years 2000 to 2008 had a superior survival rate when compared with earlier decades (P = <0 .001). Statistically significant improvements in overall survival were also found for patients who received surgical resections, and adjuvant radiation treatment versus no radiation (P-values <0.001). Young age was also found to be highly predictive of improved overall survival rates when separated into age groups as well as when studied as a continuous variable.
Clinical pretreatment and treatment factors, including young age at diagnosis, Asian/Pacific Islander ethnicity, recent year of diagnosis, surgical resection and the use of adjuvant radiation therapy favorably influence survival in patients diagnosed with glioblastoma.
All data were obtained from the United States Surveillance Epidemiology and End Results (SEER) database.
Authors’ original file for figure 112957_2011_1113_MOESM1_ESM.tiff
Authors’ original file for figure 212957_2011_1113_MOESM2_ESM.tiff
Authors’ original file for figure 312957_2011_1113_MOESM3_ESM.tiff
Authors’ original file for figure 412957_2011_1113_MOESM4_ESM.tiff
Authors’ original file for figure 512957_2011_1113_MOESM5_ESM.tiff
Authors’ original file for figure 612957_2011_1113_MOESM6_ESM.tiff
Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO, European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups National Cancer Institute of Canada Clinical Trials Group: Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005, 352: 987-996. 10.1056/NEJMoa043330. CrossRefPubMed
Siker ML, Wang M, Porter K, Nelson DF, Curran WJ, Michalski JM, Souhami L, Chakravarti A, Yung WK, Delrowe J, Coughlin CT, Mehta MP: Age as an independent prognostic factor in patients with glioblastoma: a Radiation Therapy Oncology Group and American College of Surgeons National Cancer Data Base comparison. J Neurooncol. 2011, 104: 351-356. 10.1007/s11060-010-0500-6. CrossRefPubMed
Burton EC, Lamborn KR, Forsyth P, Scott J, O’Campo J, Uyehara-Lock J, Prados M, Berger M, Passe S, Uhm J, O’Neill BP, Jenkins RB, Aldape KD: Aberrant p53, mdm2, and proliferation differ in glioblastomas from long-term compared with typical survivors. Clin Cancer Res. 2002, 8: 180-187. PubMed
Kuhnt D, Becker A, Ganslandt O, Bauer M, Buchfelder M, Nimsky C: Correlation of the extent of tumor volume resection and patient survival in surgery of glioblastoma multiforme with high-field intraoperative MRI guidance. Neuro Oncol. 2011, 13: 1339-1348. 10.1093/neuonc/nor133. PubMedCentralCrossRefPubMed
Curran WJ, Scott CB, Horton J, Nelson JS, Weinstein AS, Fischbach AJ, Chang CH, Rotman M, Asbell SO, Krisch RE: Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst. 1993, 85: 704-710. 10.1093/jnci/85.9.704. CrossRefPubMed
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, 95: 190-198. 10.3171/jns.2001.95.2.0190. CrossRefPubMed
Erpolat OP, Akmansu M, Goksel F, Bora H, Yaman E, Buyukberber S: Outcome of newly diagnosed glioblastoma patients treated by radiotherapy plus concomitant and adjuvant temozolomide: a long-term analysis. Tumori. 2009, 95: 191-197. PubMed
Darefsky AS, King JT, Dubrow R: Adult glioblastoma multiforme survival in the temozolomide era: a population-based analysis of surveillance, epidemiology, and end results registries. Cancer. 2011, Epub ahead of print
Sneed PK, Prados MD, McDermott MW, Larson DA, Malec MK, Lamborn KR, Davis RL, Weaver KA, Wara WM, Phillips TL: Large effect of age on the survival of patients with glioblastoma treated with radiotherapy and brachytherapy boost. Neurosurgery. 1995, 36: 898-903. 10.1227/00006123-199505000-00002. discussion 903–904 CrossRefPubMed
Ohgaki H, Dessen P, Jourde B, Horstmann S, Nishikawa T, Di Patre PL, Burkhard C, Schuler D, Probst-Hensch NM, Maiorka PC, Baeza N, Pisani P, Yonekawa Y, Yasargil MG, Lütolf UM, Kleihues P: Genetic pathways to glioblastoma: a population-based study. Cancer Res. 2004, 64: 6892-6899. 10.1158/0008-5472.CAN-04-1337. CrossRefPubMed
Burzynski SR, Lewy RI, Weaver R, Janicki T, Jurida G, Khan M, Larisma CB, Paszkowiak J, Szymkowski B: Long-term survival and complete response of a patient with recurrent diffuse intrinsic brain stem glioblastoma multiforme. Integr Cancer Ther. 2004, 3: 257-261. 10.1177/1534735404267748. CrossRefPubMed
Nieder C, Astner ST, Molls M, Grosu AL: Analysis of long-term survivors of glioblastoma multiforme in a single institution with aggressive local retreatment protocol. Anticancer Res. 2007, 27: 2993-2996. PubMed
Sabel M, Reifenberger J, Weber RG, Reifenberger G, Schmitt HP: Long-term survival of a patient with giant cell glioblastoma. Case report. J Neurosurg. 2001, 94: 605-611. PubMed
Scoccianti S, Magrini SM, Ricardi U, Detti B, Buglione M, Sotti G, Krengli M, Maluta S, Parisi S, Bertoni F, Mantovani C, Tombolini V, De Renzis C, Lioce M, Fatigante L, Fusco V, Muto P, Berti F, Rubino G, Cipressi S, Fariselli L, Lupattelli M, Santoni R, Pirtoli L, Biti G: Patterns of care and survival in a retrospective analysis of 1059 patients with glioblastoma multiforme treated between 2002 and 2007: a multicenter study by the Central Nervous System Study Group of Airo (italian Association of Radiation Oncology). Neurosurgery. 2010, 67: 446-458. 10.1227/01.NEU.0000371990.86656.E8. CrossRefPubMed
Filippini G, Falcone C, Boiardi A, Broggi G, Bruzzone MG, Caldiroli D, Farina R, Farinotti M, Fariselli L, Finocchiaro G, Giombini S, Pollo B, Savoiardo M, Solero CL, Valsecchi MG, Brain Cancer Register of the Fondazione IRCCS (Istituto Ricovero e Cura a Carattere Scientifico) Istituto Neurologico Carlo Besta: Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma. Neuro Oncol. 2008, 10: 79-87. 10.1215/15228517-2007-038. PubMedCentralCrossRefPubMed
Allahdini F, Amirjamshidi A, Reza-Zarei M, Abdollahi M: Evaluating the prognostic factors effective on the outcome of patients with glioblastoma multiformis: does maximal resection of the tumor lengthen the median survival?. World Neurosurg. 2010, 73: 128-134. 10.1016/j.wneu.2009.06.001. discussion e116 CrossRefPubMed
Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, Ludwin SK, Allgeier A, Fisher B, Belanger K, Hau P, Brandes AA, Gijtenbeek J, Marosi C, Vecht CJ, Mokhtari K, Wesseling P, Villa S, Eisenhauer E, Gorlia T, Weller M, Lacombe D, Cairncross JG, Mirimanoff RO, European Organisation for Research and Treatment of Cancer Brain Tumour and Radiation Oncology Groups National Cancer Institute of Canada Clinical Trials Group: Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol. 2009, 10: 459-466. 10.1016/S1470-2045(09)70025-7. CrossRefPubMed
Sano T, Lin H, Chen X, Langford LA, Koul D, Bondy ML, Hess KR, Myers JN, Hong YK, Yung WK, Steck PA: Differential expression of MMAC/PTEN in glioblastoma multiforme: relationship to localization and prognosis. Cancer Res. 1999, 59: 1820-1824. PubMed
Bredel M, Scholtens DM, Yadav AK, Alvarez AA, Renfrow JJ, Chandler JP, Yu IL, Carro MS, Dai F, Tagge MJ, Ferrarese R, Bredel C, Phillips HS, Lukac PJ, Robe PA, Weyerbrock A, Vogel H, Dubner S, Mobley B, He X, Scheck AC, Sikic BI, Aldape KD, Chakravarti A, Harsh GR: NFKBIA deletion in glioblastomas. N Engl J Med. 2011, 364: 627-637. 10.1056/NEJMoa1006312. PubMedCentralCrossRefPubMed
Wiencke JK, Aldape K, McMillan A, Wiemels J, Moghadassi M, Miike R, Kelsey KT, Patoka J, Long J, Wrensch M: Molecular features of adult glioma associated with patient race/ethnicity, age, and a polymorphism in O6-methylguanine-DNA-methyltransferase. Cancer Epidemiol Biomarkers Prev. 2005, 14: 1774-1783. 10.1158/1055-9965.EPI-05-0089. CrossRefPubMed
Wiemels JL, Wilson D, Patil C, Patoka J, McCoy L, Rice T, Schwartzbaum J, Heimberger A, Sampson JH, Chang S, Prados M, Wiencke JK, Wrensch M: IgE, allergy, and risk of glioma: update from the San Francisco Bay Area Adult Glioma Study in the temozolomide era. Int J Cancer. 2009, 125: 680-687. 10.1002/ijc.24369. PubMedCentralCrossRefPubMed
- Effect of pretreatment clinical factors on overall survival in glioblastoma multiforme: a Surveillance Epidemiology and End Results (SEER) population analysis
Sudheer R Thumma
Robert K Fairbanks
Wayne T Lamoreaux
Alexander R Mackay
John J Demakas
Barton S Cooke
Ameer L Elaimy
Peter W Hanson
Christopher M Lee
- BioMed Central
Neu im Fachgebiet Chirurgie
Mail Icon II