Glioblastoma in the setting of prior lower grade gliomas - insights from SEER database

Abstract

IntroductionSecondary glioblastomas (GBs) constitute a small subset of all GBs and tend to arise after a lower grade glioma. Though knowledge regarding this subset has gained traction in recent years, its definition continues to evolve, complicating its clinical management. Investigation of epidemiology and survival patterns may help provide needed insights.ResultsThe age at GB diagnosis is significantly lower (46.22 vs 60.25 years) for group B. The distribution among type of GB (glioblastoma, giant cell glioblastoma, or gliosarcoma) was significantly different, with no diagnosis of giant cell GB in Group B. Compared to Group A, Group B exhibited a higher proportion of females, not married, smaller tumors, no GTR, and no radiation (all p < 0.05). GB-related observed survivals were comparable. Cox regression with inclusion of co-variates reveal no significant influence of GB group on observed survival. Regarding group B, mean age was 40.197 for diagnosis of initial lower grade glioma. The most common initial ICD-O-3 pathology was oligodendroglioma, NOS; astrocytoma, NOS; astrocytoma, anaplastic; and mixed glioma.MethodsThe SEER-18 registry was queried for patients with GBs. Patients were further classified into two GB groups: Group A – those with GB as the only primary tumor, and Group B – those with GB as a 2nd primary or subsequent tumor and with history of lower grade gliomas. Demographics and clinical factors were compared between group A and B. Appropriate statistics were employed to calculate incidences and differences among factors and GB-related survivals between the groups.ConclusionsOverall, Group B develops GBs at an earlier age, but observed survival remains similar to those with GBs as the only primary. Moreover, this subset also exhibit different proportions of the types of GBs, and well as differences in other key clinical factors (namely, gender and tumor size at presentation). Prior treatments for lower grade gliomas likely explain some of the differences noted regarding management course after diagnosis of GB.

Identification of thioredoxin domain containing family members' expression pattern and prognostic value in diffuse gliomas via in silico analysis

“…Surgery, radiation therapy, chemotherapy or a combined approach is used as a standard treatment regimen for LGG. 32 Its treatment is crucial based on the fact that it can evolve into secondary GBM which carries a notorious therapy‐resistant nature 33 ; hence, the treatment success is crucial for LGGs. In order to understand the possible contribution of TXNDC5 in this process, we investigated TXNDC5 levels in LGG patients having primary tumors.…”

Utility of Administrative Databases and Big Data on Understanding Glioma Treatment—A Systematic Review

“…Multiple studies have evaluated glioma by including either LGG as a broad category or comparing LGG with HGG. 1 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 Several studies evaluated the epidemiology of gliomas and demonstrated increased likelihood in Caucasians, older, or male patients, patients with prior smoking history, women with prior breast cancer treatment, and insured patients. 13 14 15 16 19 Plascak et al evaluated 24,230 glioma patients using the SEER database between 2000 and 2006; they showed a greater incidence of gliomas in countries with higher socioeconomic status, which suggested unequal distribution of diagnostic resources.…”

“…These studies have suggested that White race, younger age, more recent diagnosis, lower WHO grade or histology, marital status, better socioeconomic status, EOR, radiotherapy, radiochemotherapy, treatment at high-volume facilities, and tumor size positively impact patient prognosis. 1,4,16,17,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Missios et al evaluated 21,384 cases of glioma between 2005 and 2011 using the National Inpatient Sample (NIS) database and showed that perioperative complications were increased by greater age, coagulopathy, coronary artery disease, congestive heart failure, and smoking history. 37 Although these studies have had an impact by identifying consistent risk and prognostic factors, they are limited by aggregating glioma types, mostly as a limitation of lacking molecular data in nearly all multicenter databases.…”