What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome
BackgroundGlioblastoma 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 populat...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1249366/full |
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| author | B. Fekete B. Fekete K. Werlenius K. Werlenius M. Tisell M. Tisell A. Pivodic A. Smits A. Smits A. S. Jakola A. S. Jakola B. Rydenhag B. Rydenhag |
| author_facet | B. Fekete B. Fekete K. Werlenius K. Werlenius M. Tisell M. Tisell A. Pivodic A. Smits A. Smits A. S. Jakola A. S. Jakola B. Rydenhag B. Rydenhag |
| author_sort | B. Fekete |
| collection | DOAJ |
| description | BackgroundGlioblastoma 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.MethodsWe 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.ResultsMedian 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.ConclusionThe 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. |
| first_indexed | 2024-03-12T12:16:47Z |
| format | Article |
| id | doaj.art-8ac32e58bc6e465d96bcc307ea66d3a8 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-12T12:16:47Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-8ac32e58bc6e465d96bcc307ea66d3a82023-08-30T12:26:59ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-08-011010.3389/fsurg.2023.12493661249366What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcomeB. Fekete0B. Fekete1K. Werlenius2K. Werlenius3M. Tisell4M. Tisell5A. Pivodic6A. Smits7A. Smits8A. S. Jakola9A. S. Jakola10B. Rydenhag11B. Rydenhag12Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Oncology, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Oncology, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Neurology, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, SwedenBackgroundGlioblastoma 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.MethodsWe 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.ResultsMedian 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.ConclusionThe 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.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1249366/fullglioblastomapopulation-basedsurvivalprognostic factorstreatment |
| spellingShingle | B. Fekete B. Fekete K. Werlenius K. Werlenius M. Tisell M. Tisell A. Pivodic A. Smits A. Smits A. S. Jakola A. S. Jakola B. Rydenhag B. Rydenhag What predicts survival in glioblastoma? A population-based study of changes in clinical management and outcome Frontiers in Surgery glioblastoma population-based survival prognostic factors treatment |
| 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 | glioblastoma population-based survival prognostic factors treatment |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1249366/full |
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