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

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

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

Thummaetal.WorldJournalofSurgicalOncology2012,10:75 /content/10/1/75 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH OpenAccess Effectofpretreatmentclinicalfactorsonoverall survivalinglioblastomamultiforme:aSurveillance EpidemiologyandEndResults(SEER)population analysis SudheerRThumma ,RobertKFairbanks ,WayneTLamoreaux ,AlexanderRMackay ,JohnJDemakas1,4, 1,2 1,2 1,2 1,3 BartonSCooke ,AmeerLElaimy ,PeterWHanson1,2andChristopherMLee1,2,5* 1 1,2 Abstract Background:GlioblastomaMultiforme(GBM)isoneofthemostaggressiveprimarybraintumorsandisassociated withadismalprognosis.Themediansurvivalaftertheprimarydiagnosisremainspoor,evenaftermultimodal treatmentapproaches.However,afewpatientshavebeenreportedtohavelongtermsurvivalgreaterthanthree years.Anumberofstudieshaveattemptedtodefinefactorscapableofpredictinglongtermoutcomesinspecific patientgroups.ThisarticlereportstheoutcomesofaverylargegroupofpatientsdiagnosedwithGBM,and analyzesspecificprognosticfactorsknowntoinfluencesurvivalinthesepatients. Methods:WeusedtheSurveillance,Epidemiology,andEndResults(SEER)databaseoftheUSNationalCancer Institute(NCI)toinvestigatevariouspatient-relatedandtreatment-relatedfactorsthatcouldinfluencethelong termsurvivalinpatientsdiagnosedwithglioblastoma.Atotalof34,664patientsaged20yearsorolderwitha diagnosisofGBMduringtheyears1973to2008werestudied.Overallsurvivaloutcomeswereexaminedwith Kaplan-MeiersurvivalanalysisandCoxhazardmodels. Results:Asian/PacificIslandershadabettersurvivalcomparedtothewhitepopulation(P=0.001).Patients diagnosedwithGBMduringtheyears2000to2008hadasuperiorsurvivalratewhencomparedwithearlier decades(P=0.001).Statisticallysignificantimprovementsinoverallsurvivalwerealsofoundforpatientswho receivedsurgicalresections,andadjuvantradiationtreatmentversusnoradiation(P-values0.001).Youngagewas alsofoundtobehighlypredictiveofimprovedoverallsurvivalrateswhenseparatedintoagegroupsaswellas whenstudiedasacontinuousvariable. Conclusions:Clinicalpretreatmentandtreatmentfactors,inc