Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Cancer. 2012 Nov 15;118(22):5608-13. doi: 10.1002/cncr.27590. Epub 2012 May 8.
Advances in glioblastoma care have resulted in a larger proportion of patients surviving beyond 2 years after diagnosis. It is not clear how long-term survivors should be counseled with respect to future prognosis, or what factors influence that prognosis. The conditional probability of survival was evaluated from multiple time points in patients with glioblastoma, using Surveillance, Epidemiology, and End Results (SEER) data.
Patients diagnosed with glioblastoma from 1998 to 2008 who were treated with radiation-containing regimens were identified within SEER data. Conditional survival probabilities from multiple survival points were calculated. Cox proportional hazards models were constructed to identify predictors of survival from diagnosis and from 1 and 2 years after diagnosis.
A total of 10,022 patients with glioblastoma met study inclusion criteria; median survival was 12.61 months. Conditional probability of surviving an additional 2 years ranged from 19.8% at diagnosis to 65.9% at 5 years after diagnosis. The proportion of patients surviving 12 months from time of diagnosis as well as from 6, 12, and 18 months after diagnosis was significantly higher in patients diagnosed in 2005 through 2008 than those diagnosed in 1998 through 2004. Of demographic and treatment-related factors evaluated, only age was associated with hazard of death at diagnosis and 1 and 3 years after diagnosis (P < .0001 at each time point).
Patients surviving past 2 years from diagnosis have a relatively favorable conditional probability of survival into the future compared to newly diagnosed patients. This effect becomes more pronounced with increasing time since diagnosis. These data will assist in the counseling of glioblastoma survivors.
胶质母细胞瘤治疗方面的进步使得越来越多的患者在诊断后能够存活 2 年以上。目前尚不清楚应如何为长期存活患者提供预后相关咨询，以及哪些因素会影响预后。本研究使用监测、流行病学和最终结果（Surveillance, Epidemiology, and End Results，SEER）数据库，评估了胶质母细胞瘤患者在多个时间点的生存条件概率。
在 SEER 数据库中，我们确定了 1998 年至 2008 年间接受含放疗方案治疗的胶质母细胞瘤患者。计算了多个生存时间点的条件生存概率。构建 Cox 比例风险模型，以确定从诊断开始和从诊断后 1 年和 2 年的生存预测因素。
共有 10022 名胶质母细胞瘤患者符合研究纳入标准；中位生存时间为 12.61 个月。诊断后额外存活 2 年的条件概率从诊断时的 19.8%到诊断后 5 年的 65.9%不等。与 1998 年至 2004 年诊断的患者相比，2005 年至 2008 年诊断的患者在诊断后 12 个月以及 6、12 和 18 个月时的 12 个月生存率以及从诊断开始、1 年和 3 年时的生存率均显著更高。在评估的人口统计学和治疗相关因素中，只有年龄与诊断时以及诊断后 1 年和 3 年的死亡风险相关（在每个时间点 P＜0.0001）。
与新诊断的患者相比，诊断后存活超过 2 年的患者未来具有相对较好的生存条件概率。随着时间的推移，这种效果变得更加明显。这些数据将有助于为胶质母细胞瘤幸存者提供咨询服务。
