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2010年至2016年在美国诊断出的长期胶质母细胞瘤幸存者的特征。

Characteristics of long-term glioblastoma survivors diagnosed from 2010 to 2016 in the United States.

作者信息

Ballard Christine Ann Pittman, Wang Yubo, Kruchko Carol, Barnholtz-Sloan Jill S, Li Yunqian, Ostrom Quinn T

机构信息

Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA.

Department of Neurosurgery, First Hospital of Jilin University, Jilin, PR China.

出版信息

Cancer Epidemiol. 2025 Aug;97:102810. doi: 10.1016/j.canep.2025.102810. Epub 2025 Apr 17.

Abstract

BACKGROUND

Glioblastoma (GBM) is the most common malignant primary central nervous system (CNS) tumor, accounting for half (50.9 %) of all malignant tumors diagnosed in the US. We conducted a population-based analysis using Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries (NPCR) survival database investigate which patient- and tumor-level factors are characteristic of long-term survivors (LTS) of GBM.

METHODS

Individual-level survival data containing diagnoses of primary GBM were obtained from the NPCR survival database for cases diagnosed during the period of January 1st, 2010 to December 31st, 2016, and followed through December 31st, 2019. Differences in LTS (>36-months) were investigated using χ tests and multivariable logistic regression. Frequency of IDHmut-GBM by age was estimated in the same dataset from 2018 to 2021.

RESULTS

Of the included GBM, 11.6 % met criteria for LTS. After adjustment for known prognostic factors, males (OR=0.78, p < 0.001) and age > 60 at diagnosis, were all significantly associated with decreased odds of LTS (70-79 years O =0.48, 80 + years OR=021, both p < 0.001). Frequency of IDHmut-GBM peaked from 25 to 34, with < 5 % of GBM in those > 50 having IDHmut-GBM. In a sensitivity analysis in those > 50 diagnosis, both male sex and age remained significant predictors of LTS CONCLUSION: There are multiple patient- and tumor-level factors that are associated with improved survival in GBM, with the strongest effect sizes in the multivariable models being due to age. These results demonstrate substantial heterogeneity in GBM prognosis and emphasize the distinct survival advantage associated with age at diagnosis.

摘要

背景

胶质母细胞瘤(GBM)是最常见的原发性中枢神经系统(CNS)恶性肿瘤,占美国诊断出的所有恶性肿瘤的一半(50.9%)。我们利用疾病控制与预防中心(CDC)的国家癌症登记计划(NPCR)生存数据库进行了一项基于人群的分析,以调查哪些患者和肿瘤层面的因素是GBM长期幸存者(LTS)的特征。

方法

从NPCR生存数据库中获取2010年1月1日至2016年12月31日期间诊断为原发性GBM的个体层面生存数据,并随访至2019年12月31日。使用χ检验和多变量逻辑回归研究LTS(>36个月)的差异。在同一数据集中估计2018年至2021年不同年龄的异柠檬酸脱氢酶(IDH)突变型GBM的频率。

结果

纳入的GBM中,11.6%符合LTS标准。在对已知预后因素进行调整后,男性(比值比[OR]=0.78,p<0.001)和诊断时年龄>60岁均与LTS几率降低显著相关(70 - 79岁OR = 0.48,80岁及以上OR = 0.21,均p<0.001)。IDH突变型GBM的频率在25至34岁达到峰值,50岁以上的GBM患者中IDH突变型GBM的比例<5%。在50岁以上诊断患者的敏感性分析中,男性和年龄仍然是LTS的显著预测因素。结论:GBM患者生存改善与多个患者和肿瘤层面的因素相关,多变量模型中效应大小最强的是年龄。这些结果表明GBM预后存在显著异质性,并强调了与诊断时年龄相关的独特生存优势。

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