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. 2012 May 3:10:75.
doi: 10.1186/1477-7819-10-75.

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

Sudheer R Thumma  1 , Robert K Fairbanks, Wayne T Lamoreaux, Alexander R Mackay, John J Demakas, Barton S Cooke, Ameer L Elaimy, Peter W Hanson, Christopher M Lee
Affiliations

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

Sudheer R Thumma et al. World J Surg Oncol. .

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.

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Figures

Figure 1
Figure 1
Survival curves of patients with GBM by racial group.
Figure 2
Figure 2
Survival curves of patients with GBM by diagnosis year groups.
Figure 3
Figure 3
Survival curves of patients with GBM by radiation treatment groups.
Figure 4
Figure 4
Survival curves of patients with GBM by extent of surgery groups.
Figure 5
Figure 5
Survival curves of patients with GBM by age groups.
Figure 6
Figure 6
Survival curves of patients with GBM < 50 years old by 10-year age bands.
See this image and copyright information in PMC

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