The Gamma Knife of Spokane, Spokane, WA, USA.
World J Surg Oncol. 2012 May 3;10:75. doi: 10.1186/1477-7819-10-75.
Glioblastoma Multiforme (GBM) is one of the most aggressive primary brain tumors and is associated with a dismal prognosis. The median survival after the primary diagnosis remains poor, even after multimodal treatment approaches. However, a few patients have been reported to have long term survival greater than three years. A number of studies have attempted to define factors capable of predicting long term outcomes in specific patient groups. This article reports the outcomes of a very large group of patients diagnosed with GBM, and analyzes specific prognostic factors known to influence survival in these patients.
We used the Surveillance, Epidemiology, and End Results (SEER) database of the US National Cancer Institute (NCI) to investigate various patient-related and treatment-related factors that could influence the long term survival in patients diagnosed with glioblastoma. A total of 34,664 patients aged 20 years or older with a diagnosis of GBM during the years 1973 to 2008 were studied. Overall survival outcomes were examined with Kaplan-Meier survival analysis and Cox hazard models.
Asian/Pacific Islanders had a better survival compared to the white population (P = <0.001). Patients diagnosed with GBM during the years 2000 to 2008 had a superior survival rate when compared with earlier decades (P = <0 .001). Statistically significant improvements in overall survival were also found for patients who received surgical resections, and adjuvant radiation treatment versus no radiation (P-values <0.001). Young age was also found to be highly predictive of improved overall survival rates when separated into age groups as well as when studied as a continuous variable.
Clinical pretreatment and treatment factors, including young age at diagnosis, Asian/Pacific Islander ethnicity, recent year of diagnosis, surgical resection and the use of adjuvant radiation therapy favorably influence survival in patients diagnosed with glioblastoma.
All data were obtained from the United States Surveillance Epidemiology and End Results (SEER) database.
多形性胶质母细胞瘤（GBM）是最具侵袭性的原发性脑肿瘤之一，预后不良。即使采用多模式治疗方法，原发性诊断后的中位生存期仍然很差。然而，已有少数患者报告生存期超过三年。许多研究试图确定能够预测特定患者群体长期结局的因素。本文报告了一组非常大量的诊断为 GBM 的患者的结果，并分析了已知影响这些患者生存的特定预后因素。
我们使用美国国家癌症研究所（NCI）的监测、流行病学和最终结果（SEER）数据库，研究了可能影响诊断为胶质母细胞瘤的患者长期生存的各种与患者相关和治疗相关的因素。共研究了 1973 年至 2008 年间年龄在 20 岁或以上被诊断为 GBM 的 34664 名患者。使用 Kaplan-Meier 生存分析和 Cox 风险模型检查总体生存结果。
与白人相比，亚洲/太平洋岛民的生存情况更好（P<0.001）。与早期几十年相比，2000 年至 2008 年被诊断为 GBM 的患者的生存率更高（P<0.001）。接受手术切除和辅助放疗与未放疗的患者的总体生存率也有统计学显著改善（P 值<0.001）。还发现，年龄较小与生存率的提高高度相关，无论是按年龄组划分还是作为连续变量研究。
临床治疗前和治疗因素，包括诊断时的年龄较小、亚洲/太平洋岛民种族、最近的诊断年份、手术切除和辅助放疗的使用，均对诊断为胶质母细胞瘤的患者的生存产生有利影响。
所有数据均来自美国监测、流行病学和最终结果（SEER）数据库。
