Champeaux Depond Charles, Bauchet Luc, Elhairech Dahmane, Tuppin Philippe, Jecko Vincent, Weller Joconde, Metellus Philippe
Department of Neurosurgery, Hôpital privé Clairval - Ramsay Santé, Marseille, France.
Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
Brain Tumor Res Treat. 2024 Jul;12(3):162-171. doi: 10.14791/btrt.2024.0020.
This study aimed to assess the overall survival (OS) of patients after high-grade glioma (HGG) resection and to search for associated prognostic factors.
A random sample of cases was extracted from the French medico-administrative national database, Système National des Données de Santé (SNDS). We solely considered the patients who received chemoradiotherapy with temozolomide (TMZ/RT) after HGG surgery. Statistical survival methods were implemented.
A total of 1,438 patients who had HGG resection at 58 different institutions between 2008 and 2019 were identified. Of these, 34.8% were female, and the median age at HGG resection was 63.2 years (interquartile range [IQR], 55.6-69.4 years). Median OS was 1.69 years (95% confidence interval [CI], 1.63-1.76), i.e., 20.4 months. Median age at death was 65.5 years (IQR, 58.5-71.8). OS at 1, 2, and 5 years was 78.5% (95% CI, 76.4-80.7), 40.3% (95% CI, 37.9-43), and 11.8% (95% CI, 10.2-13.6), respectively. In the adjusted Cox regression, female gender (HR=0.71; 95% CI, 0.63-0.79; <0.001), age at HGG surgery (HR=1.02; 95% CI, 1.02-1.03; <0.001), TMZ treatment over 6 months after HGG surgery (HR=0.36; 95% CI, 0.32-0.4; <0.001), bevacizumab (HR=1.22; 95% CI, 1.09-1.37; <0.001), and redo surgery (HR=0.79; 95% CI, 0.67-0.93; =0.005) remained significantly associated with the outcome.
The SNDS is a reliable source for studying the outcome of HGG patients. OS is better in younger patient, female gender, and those who complete concomitant chemoradiotherapy. Redo surgery for HGG recurrence was also associated with prolonged survival.
本研究旨在评估高级别胶质瘤（HGG）切除术后患者的总生存期（OS），并寻找相关的预后因素。
从法国国家医疗管理数据库国家卫生数据系统（SNDS）中提取病例的随机样本。我们仅考虑HGG手术后接受替莫唑胺同步放化疗（TMZ/RT）的患者。采用统计学生存方法。
共确定了2008年至2019年间在58个不同机构接受HGG切除的1438例患者。其中，34.8%为女性，HGG切除时的中位年龄为63.2岁（四分位间距[IQR]，55.6 - 69.4岁）。中位OS为1.69年（95%置信区间[CI]，1.63 - 1.76），即20.4个月。死亡时的中位年龄为65.5岁（IQR，58.5 - 71.8）。1年、2年和5年的OS分别为78.5%（95% CI，76.4 - 80.7）、40.3%（95% CI，37.9 - 43）和11.8%（95% CI，10.2 - 13.6）。在调整后的Cox回归中，女性性别（HR = 0.71；95% CI，0.63 - 0.79；<0.001）、HGG手术时的年龄（HR = 1.02；95% CI，1.02 - 1.03；<0.001）、HGG手术后超过6个月的TMZ治疗（HR = 0.36；95% CI，0.32 - 0.4；<0.001）、贝伐单抗（HR = 1.22；95% CI，1.09 - 1.37；<0.001）和再次手术（HR = 0.79；95% CI，0.67 - 0.93；=0.005）仍与预后显著相关。
SNDS是研究HGG患者预后的可靠来源。年轻患者、女性以及完成同步放化疗的患者OS较好。HGG复发后的再次手术也与生存期延长相关。
