Steinbjørn Hansen1,2, Birthe Krogh Rasmussen3, René Johannes Laursen4, Michael Kosteljanetz5, Henrik Schultz6, Bente Mertz Nørgård7,8, Rikke Guldberg8, Kim Oren Gradel7,8. 1. Department of Oncology, Odense University Hospital, Odense, Denmark. steinbjoern.hansen@rsyd.dk. 2. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. steinbjoern.hansen@rsyd.dk. 3. Department of Neurology, Nordsjaelland Hospital, Hilleroed, Denmark. 4. Department of Neurosurgery, Aalborg University Hospital, Aalborg, Denmark. 5. Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark. 6. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. 7. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. 8. Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
Abstract
BACKGROUND: As many glioblastoma patients are in a poor condition they are unable to undergo the full treatment documented in clinical trials. We aimed to examine the survival and its relationship to clinical characteristics and treatment in a nationwide population of glioblastoma patients in Denmark. METHODS: We included prospectively recorded clinical data from 1364 adult patients with histologically verified glioblastoma from the Danish Neuro-Oncology Registry, 2009-2014. RESULTS: The age standardized incidence rate was 6.3/100,000 person-years for males and 3.9 for females and the median age was 66 years. The median overall survival was 11.2 months. There was an independently significant prognostic effect of age, performance status, cognitive symptoms, tumor diameter, multifocality, crossing midline, and contrast enhancement. For partial and total resection compared to biopsy only, the adjusted risk of dying was reduced by 43% (HR [CI] 0.57 [0.48-0.68]) and 51% (0.49 [0.40-0.60]), respectively. For patients receiving a partial and full radiochemotherapy regimen compared to no postsurgical treatment, the risk reduction was 56% (HR [CI] 0.44 [0.37-0.53]) and 70% (0.30 [0.25-0.35]), respectively. The full radiochemotherapy regimen was only allocated to 50% of the patients, 29% among the oldest (70+ years) and 60% among the younger (18-69 years). CONCLUSIONS: Glioblastoma patients had a poor overall survival but with several specific independent prognostic factors. Extensive cancer treatment was associated with an increasing survival in all age groups, but only half of the patients were sufficiently fit for a full regimen of postoperative combined radiochemotherapy.
BACKGROUND: As many glioblastomapatients are in a poor condition they are unable to undergo the full treatment documented in clinical trials. We aimed to examine the survival and its relationship to clinical characteristics and treatment in a nationwide population of glioblastomapatients in Denmark. METHODS: We included prospectively recorded clinical data from 1364 adult patients with histologically verified glioblastoma from the Danish Neuro-Oncology Registry, 2009-2014. RESULTS: The age standardized incidence rate was 6.3/100,000 person-years for males and 3.9 for females and the median age was 66 years. The median overall survival was 11.2 months. There was an independently significant prognostic effect of age, performance status, cognitive symptoms, tumor diameter, multifocality, crossing midline, and contrast enhancement. For partial and total resection compared to biopsy only, the adjusted risk of dying was reduced by 43% (HR [CI] 0.57 [0.48-0.68]) and 51% (0.49 [0.40-0.60]), respectively. For patients receiving a partial and full radiochemotherapy regimen compared to no postsurgical treatment, the risk reduction was 56% (HR [CI] 0.44 [0.37-0.53]) and 70% (0.30 [0.25-0.35]), respectively. The full radiochemotherapy regimen was only allocated to 50% of the patients, 29% among the oldest (70+ years) and 60% among the younger (18-69 years). CONCLUSIONS:Glioblastomapatients had a poor overall survival but with several specific independent prognostic factors. Extensive cancer treatment was associated with an increasing survival in all age groups, but only half of the patients were sufficiently fit for a full regimen of postoperative combined radiochemotherapy.
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