Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma

• Published in: Scientific reports 2021-04, Vol.11 (1), p.9321-9321, Article 9321
• Main Authors: Liu, Zhuo-yi, Feng, Song-shan, Zhang, Yi-hao, Zhang, Li-yang, Xu, Sheng-chao, Li, Jing, Cao, Hui, Huang, Jun, Fan, Fan, Cheng, Li, Jiang, Jun-yi, Cheng, Quan, Liu, Zhi-xiong
• Format: Article
• Language: English
• Subjects: 631/67/1059; 631/67/1922; 631/67/2324; Brain cancer; Chemotherapy; Epidemiology; Frontal lobe; Glioblastoma; Humanities and Social Sciences; Mortality; multidisciplinary; Nomograms; Patients; Radiation therapy; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-88820-5

The prognostic factors and optimal treatment for the elderly patient with glioblastoma (GBM) were poorly understood. This study extracted 4975 elderly patients (≥ 65 years old) with histologically confirmed GBM from Surveillance, Epidemiology and End Results (SEER) database. Firstly, Cumulative incidence function and cox proportional model were utilized to illustrate the interference of non-GBM related mortality in our cohort. Then, the Fine-Gray competing risk model was applied to determine the prognostic factors for GBM related mortality. Age ≥ 75 years old, white race, size > 5.4 cm, frontal lobe tumor, and overlapping lesion were independently associated with more GBM related death, while Gross total resection (GTR) (HR 0.87, 95%CI 0.80–0.94, P  = 0.010), radiotherapy (HR 0.64, 95%CI 0.55–0.74, P