Improved survival of Swedish glioblastoma patients treated according to Stupp

Bruhn, Helena; Strandéus, Michael; Milos, Peter; Hallbeck, Martin; Vrethem, Magnus; Lind, Jonas

doi:10.1111/ane.12966

Cited by 21 publications

(18 citation statements)

References 27 publications

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“…Our study con rms previous ndings of a considerably poorer prognosis in butter y glioblastoma compared to glioblastoma in general, where population-based studies observed a median overall survival of nine to 11 months [22][23][24][25]. A median overall survival of 5.9 months in our cohort was comparable to the results from previous butter y glioblastoma studies, with median survival ranging from 3.2 to 5.9 months [4,5,8].…”

Section: Survivalsupporting

confidence: 90%

Butterfly Glioblastoma - the Impact of Tumor Volumes and Treatment Strategies on Clinical Outcome

Bjorland

Kurz

Fluge

et al. 2021

Preprint

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PurposeButterfly glioblastoma is a rare subgroup of glioblastoma with a bihemispheric tumor crossing the corpus callosum, and is associated with a dismal prognosis. Prognostic factors are previously sparsely described and optimal treatment approaches remain uncertain. We aimed to analyse prognostic factors in butterfly glioblastoma, and to evaluate treatment strategies and outcome in a real-world setting.MethodsWe conducted a retrospective population-based cohort study of patients diagnosed with butterfly glioblastoma in Western Norway between 01/01/2007 and 31/12/2014. Clinical data were extracted from electronic medical records. Molecular and MRI volumetric analyses were retrospectively performed. Survival analyses were performed using Kaplan-Meier method and Cox proportional hazards regression models.ResultsAmong 381 patients diagnosed with glioblastoma, 36 patients (9.4%) met the criteria for butterfly glioblastoma. Median overall survival was 5.9 months (95% CI 2.7-9.2) and three-year survival was 8.3%. Age was strongly associated with poorer outcome, with adjusted hazard ratio (HR) 1.06 (95% CI 1.03-1.10), p<0.001. Best supportive care was associated with poorer survival compared to multimodal treatment (adjusted HR 5.69 (95% CI 1.39-23.38), p=0.02).ConclusionOutcome from butterfly glioblastoma was dismal, with a median overall survival of less than six months. However, long-term survival was comparable to that observed in glioblastoma in general, and multimodal treatment was associated with longer survival. This suggests that patients with butterfly glioblastoma may benefit from a more aggressive treatment approach despite the overall poor prognosis.

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Section: Survivalsupporting

confidence: 90%

Butterfly Glioblastoma - the Impact of Tumor Volumes and Treatment Strategies on Clinical Outcome

Bjorland

Kurz

Fluge

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Our study con rms previous ndings of a considerably poorer prognosis in butter y glioblastoma compared to glioblastoma in general, where population-based studies observed a median overall survival of nine to 11 months [23][24][25][26]. A median overall survival of 5.5 months in our cohort was comparable to the results from previous butter y glioblastoma studies, with median survival ranging from 3.2 to 5.9 months [4,5,8].…”

Section: Survivalsupporting

confidence: 90%

Butterfly Glioblastoma - the Impact of Tumor Volumes and Treatment Strategies on Clinical Outcome

Bjorland

Kurz

Fluge

et al. 2021

Preprint

View full text Add to dashboard Cite

PurposeButterfly glioblastoma is a rare subgroup of glioblastoma with a bihemispheric tumor crossing the corpus callosum, and is associated with a dismal prognosis. Prognostic factors are previously sparsely described and optimal treatment approaches remain uncertain. We aimed to analyse prognostic factors in butterfly glioblastoma, and to evaluate treatment strategies and outcome in a real-world setting.MethodsWe conducted a retrospective population-based cohort study of patients diagnosed with butterfly glioblastoma in Western Norway between 01/01/2007 and 31/12/2014. Clinical data were extracted from electronic medical records. Molecular and MRI volumetric analyses were retrospectively performed. Survival analyses were performed using Kaplan-Meier method and Cox proportional hazards regression models.ResultsAmong 381 patients diagnosed with glioblastoma, 33 patients (8.7%) met the criteria for butterfly glioblastoma. Median overall survival was 5.5 months (95% CI 3.1-7.9) and three-year survival was 9.1%. Older age and mainly deep-seated tumour location were associated with poor outcome, with adjusted hazard ratio (HR) 1.06 (95% CI 1.03-1.10), p<0.001, and adjusted HR 4.58 (95% CI 1.15-18.20), p=0.03. Best supportive care was associated with poorer survival compared to multimodal treatment (adjusted HR 5.11 (95% CI 1.09-23.89), p=0.04).ConclusionOutcome from butterfly glioblastoma was dismal, with a median overall survival of less than six months. However, long-term survival was comparable to that observed in glioblastoma in general, and multimodal treatment was associated with longer survival. This suggests that patients with butterfly glioblastoma may benefit from a more comprehensive treatment approach despite the overall poor prognosis.

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“…Our study shows that the benefits of GTR, followed by CRT with temozolomide seen in clinical trials and recent population studies 4,23,31 are also applicable in an unselected population. It should be emphasised that the survival difference between cohort A and B cannot only be explained by the implementation of CRT with temozolomide since other treatment regimens have been introduced in the later years, such as postoperative MRI and the use of 5‐ALA.…”

Section: Discussionsupporting

confidence: 54%

“…Approximately 1200 cases with primary brain tumours are diagnosed yearly in Sweden 1 . Glioblastoma (GBM) is the most frequent tumour diagnosis with an incidence of 4/100.000 and the most devastating tumour with a median overall survival (OS) of less than 15 months 2‐4 …”

Section: Introductionmentioning

confidence: 99%

Initial cognitive impairment predicts shorter survival of patients with glioblastoma

Bruhn

Blystad

Milos

et al. 2021

Acta Neuro Scandinavica

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Reperfusion therapies have markedly improved the outcomes after acute ischemic stroke (AIS). 1,2 The therapeutic window has expanded, but it remains narrow for most patients. [1][2][3][4] The sooner treatment is initiated after symptom onset, the better chance for a good outcome. 5,6 Prehospital delay, which includes both patient delay and system delay, is the main reason for low reperfusion therapy rates at the stroke centres. 7,8 Patient delay denotes the time from symptom onset until contact to a healthcare professional, while system delay designates the period from this contact until arrival at the stroke centre. 9,10 Patient delay typically makes up the largest part of the

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Improved survival of Swedish glioblastoma patients treated according to Stupp

Abstract: Survival significantly improved after the implementation of the Stupp regimen in the study region of Sweden.

Cited by 21 publications

References 27 publications

Butterfly Glioblastoma - the Impact of Tumor Volumes and Treatment Strategies on Clinical Outcome

Butterfly Glioblastoma - the Impact of Tumor Volumes and Treatment Strategies on Clinical Outcome

Butterfly Glioblastoma - the Impact of Tumor Volumes and Treatment Strategies on Clinical Outcome

Initial cognitive impairment predicts shorter survival of patients with glioblastoma

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