Field Kathryn Maree, Rosenthal Mark Andrew, Yilmaz Merve, Tacey Mark, Drummond Kate
Department of Medical Oncology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Asia Pac J Clin Oncol. 2014 Jun;10(2):153-61. doi: 10.1111/ajco.12076. Epub 2013 May 22.
Despite the largely poor prognosis for patients with glioblastoma, 5-year survival approaches 10%. In many circumstances the reasons for discrepant outcomes remain unknown. This retrospective cohort study compared clinical and socio-demographic variables between long-term and poor survivors with glioblastoma.
Data from patients with glioblastoma diagnosed from 1998-2010 were accessed from two institutions. The cohort was divided into poor (<6 months), average (6-24 months) and long-term (>24 months) survivors. Clinical and socio-demographic variables were compared.
In total 529 patients were included; 221 (42%) were poor, 260 (49%) average and 48 (9%) long-term survivors. Those surviving >24 months were younger and significantly more likely to be in a higher socioeconomic status group; be of a better performance status; have a frontal lobe tumor; have a craniotomy (rather than a biopsy); have a macroscopic resection; have two or more operations; and participate in a clinical trial. Country of birth, regional versus city residence and public versus private hospital treatment were not associated with differential survival outcomes. An ordered logistic regression analysis showed that age, performance status, extent of resection and clinical trial participation were independently associated with survival.
Reassuringly, no statistically significant socio-demographic differences exist when comparing long-term and poor survivors with glioblastoma. Patients surviving more than 2 years were significantly more likely to have participated in a clinical trial. This research could contribute towards informing further research on prognostic variables for patients with glioblastoma.
尽管胶质母细胞瘤患者的预后总体较差，但5年生存率接近10%。在许多情况下，结果差异的原因仍不明。这项回顾性队列研究比较了胶质母细胞瘤长期存活者和预后较差存活者之间的临床及社会人口统计学变量。
从两个机构获取1998年至2010年诊断为胶质母细胞瘤患者的数据。该队列分为预后较差（<6个月）、中等（6 - 24个月）和长期存活者（>24个月）。比较临床及社会人口统计学变量。
共纳入529例患者；221例（42%）预后较差，260例（49%）中等，48例（9%）长期存活。存活超过24个月的患者更年轻，且更有可能属于社会经济地位较高的群体；表现状态更好；患有额叶肿瘤；接受开颅手术（而非活检）；进行了肉眼下切除；接受了两次或更多次手术；并参与了一项临床试验。出生国家、地区与城市居住情况以及公立与私立医院治疗与不同的生存结果无关。有序逻辑回归分析表明，年龄、表现状态、切除范围和参与临床试验与生存独立相关。
令人欣慰的是，在比较胶质母细胞瘤长期存活者和预后较差存活者时，不存在具有统计学意义的社会人口统计学差异。存活超过2年的患者参与临床试验的可能性显著更高。这项研究有助于为胶质母细胞瘤患者预后变量的进一步研究提供信息。
