Literature DB >> 23543729

Can the prognosis of individual patients with glioblastoma be predicted using an online calculator?

Christopher Parks1, James Heald, Gregory Hall, Ian Kamaly-Asl.   

Abstract

BACKGROUND: In an exploratory subanalysis of the European Organisation for Research and Treatment of Cancer and National Cancer Institute of Canada (EORTC/NCIC) trial data, Gorlia et al. identified a variety of factors that were predictive of overall survival, including therapy administered, age, extent of surgery, mini-mental score, administration of corticosteroids, World Health Organization (WHO) performance status, and O-methylguanine-DNA methyltransferase (MGMT) promoter methylation status. Gorlia et al. developed 3 nomograms, each intended to predict the survival times of patients with newly diagnosed glioblastoma on the basis of individual-specific combinations of prognostic factors. These are available online as a "GBM Calculator" and are intended for use in patient counseling. This study is an external validation of this calculator.
METHOD: One hundred eighty-seven patients from 2 UK neurosurgical units who had histologically confirmed glioblastoma (WHO grade IV) had their information at diagnosis entered into the GBM calculator. A record was made of the actual and predicted median survival time for each patient. Statistical analysis was performed to assess the accuracy, precision, correlation, and discrimination of the calculator.
RESULTS: The calculator gives both inaccurate and imprecise predictions. Only 23% of predictions were within 25% of the actual survival, and the percentage bias is 140% in our series. The coefficient of variance is 76%, where a smaller percentage would indicate greater precision. There is only a weak positive correlation between the predicted and actual survival among patients (R(2) of 0.07). Discrimination is inadequate as measured by a C-index of 0.62.
CONCLUSIONS: The authors would not recommend the use of this tool in patient counseling. If departments were considering its use, we would advise that a similar validating exercise be undertaken.

Entities:  

Keywords:  GBM calculator; glioblastoma, prognosis prediction

Mesh:

Year:  2013        PMID: 23543729      PMCID: PMC3714148          DOI: 10.1093/neuonc/not033

Source DB:  PubMed          Journal:  Neuro Oncol        ISSN: 1522-8517            Impact factor:   12.300


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