A Prognostic Model for Glioblastoma Patients Treated With Standard Therapy Based on a Prospective Cohort of Consecutive Non-Selected Patients From a Single Institution

Glioblastoma patients administered standard therapies, comprising maximal surgical resection, radiation therapy with concomitant and adjuvant temozolomide, have a variable prognosis with a median overall survival of 15-16 months and a 2-year overall survival of 30%. The aim of this study was to deve...

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Bibliographic Details
Published in:Frontiers in oncology 2021-02, Vol.11, p.597587
Main Authors: Abedi, Armita Armina, Grunnet, Kirsten, Christensen, Ib Jarle, Michaelsen, Signe Regner, Muhic, Aida, Møller, Søren, Hasselbalch, Benedikte, Poulsen, Hans Skovgaard, Urup, Thomas
Format: Article
Language:English
Subjects:
glioblastoma
glioma grade IV
nomogram
Oncology
overall survival
prognostic factors
progression-free survival
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Summary:Glioblastoma patients administered standard therapies, comprising maximal surgical resection, radiation therapy with concomitant and adjuvant temozolomide, have a variable prognosis with a median overall survival of 15-16 months and a 2-year overall survival of 30%. The aim of this study was to develop a prognostic nomogram for overall survival for glioblastoma patients treated with standard therapy outside clinical trials. The study included 680 consecutive, non-selected glioblastoma patients administered standard therapy as primary treatment between the years 2005 and 2016 at Rigshospitalet, Copenhagen, Denmark. The prognostic model was generated employing multivariate Cox regression analysis modeling overall survival. The following poor prognostic factors were included in the final prognostic model for overall survival: Age (10-year increase: HR = 1.18, 95% CI: 1.08-1.28, p < 0.001), ECOG performance status (PS) 1 vs. 0 (HR = 1.30, 95% CI: 1.07-1.57, p = 0.007), PS 2 vs. 0 (HR = 2.99, 95% CI: 1.99-4.50, p < 0.001), corticosteroid use (HR = 1.42, 95% CI: 1.18-1.70, p < 0.001), multifocal disease (HR = 1.63, 95% CI: 1.25-2.13, p < 0.001), biopsy vs. resection (HR = 1.35, 95% CI: 1.04-1.72, p = 0.02), un-methylated promoter of the MGMT (O -methylguanine-DNA methyltransferase) gene (HR = 1.71, 95% CI: 1.42-2.04, p < 0.001). The model was validated internally and had a concordance index of 0.65. A nomogram for overall survival was established. This model can be used for risk stratification and treatment planning, as well as improve enrollment criteria for clinical trials.
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2021.597587