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01.12.2012 | Research | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Effect of pretreatment clinical factors on overall survival in glioblastoma multiforme: a Surveillance Epidemiology and End Results (SEER) population analysis

Zeitschrift:
World Journal of Surgical Oncology > Ausgabe 1/2012
Autoren:
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
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-75) contains supplementary material, which is available to authorized users.

Competing interests

The authors of this manuscript have no conflicts of interests, ethical conflicts or financial disclosures to make regarding this paper.

Authors’ contributions

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.

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Trial Registration

All data were obtained from the United States Surveillance Epidemiology and End Results (SEER) database.
Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 3
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Authors’ original file for figure 4
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Authors’ original file for figure 5
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Authors’ original file for figure 6
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Literatur
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