Prognostic impact of obesity in newly-diagnosed glioblastoma: a secondary analysis of CeTeG/NOA-09 and GLARIUS

Purpose The role of obesity in glioblastoma remains unclear, as previous analyses have reported contradicting results. Here, we evaluate the prognostic impact of obesity in two trial populations; CeTeG/NOA-09 (n = 129) for MGMT methylated glioblastoma patients comparing temozolomide (TMZ) to lomusti...

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Published in:Journal of neuro-oncology 2022-08, Vol.159 (1), p.95-101
Main Authors: Weller, Johannes, Schäfer, Niklas, Schaub, Christina, Potthoff, Anna-Laura, Steinbach, Joachim P., Schlegel, Uwe, Sabel, Michael, Hau, Peter, Seidel, Clemens, Krex, Dietmar, Goldbrunner, Roland, Pietsch, Torsten, Tzaridis, Theophilos, Zeyen, Thomas, Borger, Valeri, Güresir, Erdem, Vatter, Hartmut, Herrlinger, Ulrich, Schneider, Matthias
Format: Article
Language:English
Subjects:
Bevacizumab
Brain cancer
Clinical Study
Glioblastoma
Irinotecan
Medical prognosis
Medicine
Medicine & Public Health
Neurology
Obesity
Oncology
Patients
Radiation therapy
Steroid hormones
Survival
Temozolomide
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Summary:Purpose The role of obesity in glioblastoma remains unclear, as previous analyses have reported contradicting results. Here, we evaluate the prognostic impact of obesity in two trial populations; CeTeG/NOA-09 (n = 129) for MGMT methylated glioblastoma patients comparing temozolomide (TMZ) to lomustine/TMZ, and GLARIUS (n = 170) for MGMT unmethylated glioblastoma patients comparing TMZ to bevacizumab/irinotecan, both in addition to surgery and radiotherapy. Methods The impact of obesity (BMI ≥ 30 kg/m 2 ) on overall survival (OS) and progression-free survival (PFS) was investigated with Kaplan–Meier analysis and log-rank tests. A multivariable Cox regression analysis was performed including known prognostic factors as covariables. Results Overall, 22.6% of patients (67 of 297) were obese. Obesity was associated with shorter survival in patients with MGMT methylated glioblastoma (median OS 22.9 (95% CI 17.7–30.8) vs. 43.2 (32.5–54.4) months for obese and non-obese patients respectively, p = 0.001), but not in MGMT unmethylated glioblastoma (median OS 17.1 (15.8–18.9) vs 17.6 (14.7–20.8) months, p = 0.26). The prognostic impact of obesity in MGMT methylated glioblastoma was confirmed in a multivariable Cox regression (adjusted odds ratio: 2.57 (95% CI 1.53–4.31), p 
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-022-04046-z