University of Wisconsin School of Medicine and Public Health, Department of Human Oncology, 600 Highland Ave., K4/362, Madison, WI 53792, USA.
Neuro Oncol. 2009 Dec;11(6):833-41. doi: 10.1215/15228517-2008-123.
Giant cell glioblastoma (GC) is an uncommon subtype of glioblastoma multiforme (GBM). Consequently, the epidemiology, natural history, and factors associated with outcome are not well defined. Patients diagnosed with GC from 1988 through 2004 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Outcomes were examined with Kaplan-Meier survival analysis and Cox models. For comparison, similar analyses were conducted for patients diagnosed with GBM. GC was identified in 1% of 16,430 patients diagnosed with either GC or GBM. Compared with GBM, GC showed similar gender and racial distributions. Likewise, tumor size and location were not significantly different between the two histologies. GC tended to occur in younger patients with a median age at diagnosis of 51 years, compared with 62 years for GBM. Additionally, patients with GC were more likely to undergo complete resection compared with patients with GBM. For both histologies, young age, tumor size, extent of resection, and the use of adjuvant radiation therapy (RT) were associated with improved survival. Cox modeling suggests the prognosis for GC is significantly superior to that for GBM (hazard ratio = 0.76; 95% confidence interval, 0.59-0.97) even after adjustment for factors affecting survival. GC is an uncommon GBM subtype that tends to occur in younger patients. Prospective data defining optimal treatment for GC are unavailable; however, these retrospective findings suggest that resection, as opposed to biopsy only, and adjuvant RT may improve survival. The prognosis of GC is superior to that of GBM, and long-term survival is possible, suggesting aggressive therapy is warranted.
巨细胞胶质母细胞瘤（GC）是胶质母细胞瘤多形性（GBM）的一种罕见亚型。因此，其流行病学、自然史和与结局相关的因素尚未明确。本研究在监测、流行病学和结果（SEER）数据库中确定了 1988 年至 2004 年间诊断为 GC 的患者。采用 Kaplan-Meier 生存分析和 Cox 模型评估结局。为进行比较，对诊断为 GBM 的患者进行了类似的分析。在诊断为 GC 或 GBM 的 16430 例患者中，有 1%的患者诊断为 GC。与 GBM 相比，GC 的性别和种族分布相似。同样，两种组织学类型之间肿瘤大小和位置无显著差异。GC 患者发病年龄较年轻，中位诊断年龄为 51 岁，而 GBM 为 62 岁。此外，与 GBM 相比，GC 患者更倾向于行完全切除术。对于两种组织学类型，年轻患者、肿瘤体积、切除范围和辅助放疗（RT）的使用与生存改善相关。Cox 模型表明，即使在调整影响生存的因素后，GC 的预后明显优于 GBM（风险比=0.76；95%置信区间，0.59-0.97）。GC 是一种罕见的 GBM 亚型，多见于年轻患者。目前尚无定义 GC 最佳治疗方法的前瞻性数据；然而，这些回顾性研究结果表明，与单纯活检相比，切除和辅助 RT 可能会改善生存。GC 的预后优于 GBM，长期生存是可能的，这表明应进行积极的治疗。
