Frontiers in Oncology (Feb 2021)

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

  • Armita Armina Abedi,
  • Armita Armina Abedi,
  • Kirsten Grunnet,
  • Kirsten Grunnet,
  • Ib Jarle Christensen,
  • Signe Regner Michaelsen,
  • Signe Regner Michaelsen,
  • Aida Muhic,
  • Søren Møller,
  • Søren Møller,
  • Benedikte Hasselbalch,
  • Benedikte Hasselbalch,
  • Hans Skovgaard Poulsen,
  • Hans Skovgaard Poulsen,
  • Thomas Urup,
  • Thomas Urup

DOI
https://doi.org/10.3389/fonc.2021.597587
Journal volume & issue
Vol. 11

Abstract

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BackgroundGlioblastoma 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.MethodsThe 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.ResultsThe 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.ConclusionA 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.

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