TY - JOUR

T1 - A Prognostic Model for Glioblastoma Patients Treated With Standard Therapy Based on a Prospective Cohort of Consecutive Non-Selected Patients From a Single Institution

AU - Abedi, Armita Armina

AU - Grunnet, Kirsten

AU - Christensen, Ib Jarle

AU - Michaelsen, Signe Regner

AU - Muhic, Aida

AU - Møller, Søren

AU - Hasselbalch, Benedikte

AU - Poulsen, Hans Skovgaard

AU - Urup, Thomas

PY - 2021

Y1 - 2021

N2 - Background: Glioblastoma patients administered standard therapies, comprising maximal surgical resection, radiation therapy with concomitant and adjuvant temozolomide, have a variable prognosis with a median overall survival of 15–16 months and a 2-year overall survival of 30%. The aim of this study was to develop a prognostic nomogram for overall survival for glioblastoma patients treated with standard therapy outside clinical trials. Methods: The study included 680 consecutive, non-selected glioblastoma patients administered standard therapy as primary treatment between the years 2005 and 2016 at Rigshospitalet, Copenhagen, Denmark. The prognostic model was generated employing multivariate Cox regression analysis modeling overall survival. Results: The following poor prognostic factors were included in the final prognostic model for overall survival: Age (10-year increase: HR = 1.18, 95% CI: 1.08–1.28, p < 0.001), ECOG performance status (PS) 1 vs. 0 (HR = 1.30, 95% CI: 1.07–1.57, p = 0.007), PS 2 vs. 0 (HR = 2.99, 95% CI: 1.99–4.50, p < 0.001), corticosteroid use (HR = 1.42, 95% CI: 1.18–1.70, p < 0.001), multifocal disease (HR = 1.63, 95% CI: 1.25–2.13, p < 0.001), biopsy vs. resection (HR = 1.35, 95% CI: 1.04–1.72, p = 0.02), un-methylated promoter of the MGMT (O6-methylguanine-DNA methyltransferase) gene (HR = 1.71, 95% CI: 1.42–2.04, p < 0.001). The model was validated internally and had a concordance index of 0.65. Conclusion: A nomogram for overall survival was established. This model can be used for risk stratification and treatment planning, as well as improve enrollment criteria for clinical trials.

AB - Background: Glioblastoma patients administered standard therapies, comprising maximal surgical resection, radiation therapy with concomitant and adjuvant temozolomide, have a variable prognosis with a median overall survival of 15–16 months and a 2-year overall survival of 30%. The aim of this study was to develop a prognostic nomogram for overall survival for glioblastoma patients treated with standard therapy outside clinical trials. Methods: The study included 680 consecutive, non-selected glioblastoma patients administered standard therapy as primary treatment between the years 2005 and 2016 at Rigshospitalet, Copenhagen, Denmark. The prognostic model was generated employing multivariate Cox regression analysis modeling overall survival. Results: The following poor prognostic factors were included in the final prognostic model for overall survival: Age (10-year increase: HR = 1.18, 95% CI: 1.08–1.28, p < 0.001), ECOG performance status (PS) 1 vs. 0 (HR = 1.30, 95% CI: 1.07–1.57, p = 0.007), PS 2 vs. 0 (HR = 2.99, 95% CI: 1.99–4.50, p < 0.001), corticosteroid use (HR = 1.42, 95% CI: 1.18–1.70, p < 0.001), multifocal disease (HR = 1.63, 95% CI: 1.25–2.13, p < 0.001), biopsy vs. resection (HR = 1.35, 95% CI: 1.04–1.72, p = 0.02), un-methylated promoter of the MGMT (O6-methylguanine-DNA methyltransferase) gene (HR = 1.71, 95% CI: 1.42–2.04, p < 0.001). The model was validated internally and had a concordance index of 0.65. Conclusion: A nomogram for overall survival was established. This model can be used for risk stratification and treatment planning, as well as improve enrollment criteria for clinical trials.

KW - biomarkers

KW - glioblastoma

KW - glioma grade IV

KW - MGMT = O-DNA-methylguanine methyltransferase

KW - nomogram

KW - overall survival

KW - prognostic factors

KW - progression-free survival

UR - http://www.scopus.com/inward/record.url?scp=85102435838&partnerID=8YFLogxK

U2 - 10.3389/fonc.2021.597587

DO - 10.3389/fonc.2021.597587

M3 - Journal article

C2 - 33718145

AN - SCOPUS:85102435838

VL - 11

JO - Frontiers in Oncology

JF - Frontiers in Oncology

SN - 2234-943X

M1 - 597587

ER -