Haley Gittleman1,2,3, Quinn T Ostrom1,4, L C Stetson2, Kristin Waite2,3, Tiffany R Hodges5,6, Christina H Wright5, James Wright5, Joshua B Rubin7, Michael E Berens8, Justin Lathia2,9, James R Connor10, Carol Kruchko1, Andrew E Sloan2,5,6, Jill S Barnholtz-Sloan1,2,3. 1. Central Brain Tumor Registry of the United States, Hinsdale, IL. 2. Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH. 3. Department of Population Health and Quantitative Sciences, Case Western Reserve University School of Medicine, Cleveland, OH. 4. Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX. 5. Department of Neurological Surgery, University Hospitals of Cleveland and Case Western University School of Medicine, OH. 6. Seidman Cancer Center, University Hospitals of Cleveland, OH. 7. Washington University School of Medicine, St. Louis, MO. 8. Translational Genomics Research Institute, Phoenix, AZ. 9. Cleveland Clinic, Lerner Research Institute, OH. 10. Department of Neurosurgery, Penn State Cancer Institute, Penn State, State College.
Abstract
BACKGROUND: Glioblastoma (GBM) is the most common and most malignant glioma. Nonglioblastoma (non-GBM) gliomas (WHO Grades II and III) are invasive and also often fatal. The goal of this study is to determine whether sex differences exist in glioma survival. METHODS: Data were obtained from the National Cancer Database (NCDB) for years 2010 to 2014. GBM (WHO Grade IV; N = 2073) and non-GBM (WHO Grades II and III; N = 2963) were defined using the histology grouping of the Central Brain Tumor Registry of the United States. Non-GBM was divided into oligodendrogliomas/mixed gliomas and astrocytomas. Sex differences in survival were analyzed using Kaplan-Meier and multivariable Cox proportional hazards models adjusted for known prognostic variables. RESULTS: There was a female survival advantage in patients with GBM both in the unadjusted (P = .048) and adjusted (P = .003) models. Unadjusted, median survival was 20.1 months (95% CI: 18.7-21.3 months) for women and 17.8 months (95% CI: 16.9-18.7 months) for men. Adjusted, median survival was 20.4 months (95% CI: 18.9-21.6 months) for women and 17.5 months (95% CI: 16.7-18.3 months) for men. When stratifying by age group (18-55 vs 56+ years at diagnosis), this female survival advantage appeared only in the older group, adjusting for covariates (P = .017). Women (44.1%) had a higher proportion of methylated MGMT (O6-methylguanine-DNA methyltransferase) than men (38.4%). No sex differences were found for non-GBM. CONCLUSIONS: Using the NCDB data, there was a statistically significant female survival advantage in GBM, but not in non-GBM.
BACKGROUND: Glioblastoma (GBM) is the most common and most malignant glioma. Nonglioblastoma (non-GBM) gliomas (WHO Grades II and III) are invasive and also often fatal. The goal of this study is to determine whether sex differences exist in glioma survival. METHODS: Data were obtained from the National Cancer Database (NCDB) for years 2010 to 2014. GBM (WHO Grade IV; N = 2073) and non-GBM (WHO Grades II and III; N = 2963) were defined using the histology grouping of the Central Brain Tumor Registry of the United States. Non-GBM was divided into oligodendrogliomas/mixed gliomas and astrocytomas. Sex differences in survival were analyzed using Kaplan-Meier and multivariable Cox proportional hazards models adjusted for known prognostic variables. RESULTS: There was a female survival advantage in patients with GBM both in the unadjusted (P = .048) and adjusted (P = .003) models. Unadjusted, median survival was 20.1 months (95% CI: 18.7-21.3 months) for women and 17.8 months (95% CI: 16.9-18.7 months) for men. Adjusted, median survival was 20.4 months (95% CI: 18.9-21.6 months) for women and 17.5 months (95% CI: 16.7-18.3 months) for men. When stratifying by age group (18-55 vs 56+ years at diagnosis), this female survival advantage appeared only in the older group, adjusting for covariates (P = .017). Women (44.1%) had a higher proportion of methylated MGMT (O6-methylguanine-DNA methyltransferase) than men (38.4%). No sex differences were found for non-GBM. CONCLUSIONS: Using the NCDB data, there was a statistically significant female survival advantage in GBM, but not in non-GBM.
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