Which glioblastoma multiforme patient will become a long-term survivor? A population-based study

Abstract

In this clinical and histopathological study, the frequency of long‐term glioblastoma multiforme (GBM) survivors (LTGBMSs) was determined in a population‐based study. The Alberta Cancer Registry was used to identify all patients diagnosed with GBM in Alberta between January 1, 1975, and December 31, 1991. Patient charts were reviewed and histology reexamined. LTGBMSs were defined as GBM patients surviving 3 years after diagnosis. Each LTGBMS was compared with 3 age‐, sex‐, and year of diagnosis–matched controls, and patient/treatment or tumor characteristics that predicted long‐term survival were determined. There were 689 GBMs diagnosed in the study period; 15 (2.2%) of these patients survived 3 years. LTGBMSs (average age, 43.5 ± 3.3 years) were significantly younger when compared with all GBM patients (average age, 53.0 ± 0.56 years). LTGBMSs had a higher Karnofsky Performance Status score at diagnosis compared with controls. LTGBMSs were much more likely to have had a gross total resection and adjuvant chemotherapy than control GBM patients. Tumors from LTGBMSs tended to have fewer mitoses and a significantly lower Ki‐67 cellular proliferation index compared with controls. Radiation‐induced dementia was common and disabling in LTGBMSs. In conclusion, conventionally treated GBM patients in an unselected population have a very small chance of long‐term survival. The use of aggressive surgical resection and adjuvant chemotherapy may make long‐term survival more likely in GBM patients if their performance status is high at diagnosis. Ann Neurol 1999;47:183–188

Clinical implications of quantitative real-time RT–PCR analysis of hTERT gene expression in human gliomas

“…The cases with gross total tumour excision (n ¼ 5), where no residual contrast enhancement was detected on early postoperative computed tomography scans, were excluded from analysis, as complete resection of the lesion could influence favourably the survival in GBMs (Scott et al, 1999). Among the 36 patients with subtotal resection of their lesion, 25 had hTERT positive tumours.…”

Profile of a Malignant Brain Tumor in Jamaica: an Eight Year Review, 2005 to 2012

“…The survival rates for GBM remain dismal, being approximately 3-5% at five years (5,6). According to the most recent report from the Central Brain Tumour Registry of the USA (CBTRUS), GBMs are more common in males and have a peak incidence between 75 and 84 years of age (1).…”

Perioperative single photon emission computed tomography in predicting survival of malignant glioma patients

“…Despite recent advancements in treatment modalities that currently consist of maximally safe surgical resection followed by radiation therapy plus concomitant and adjuvant temozolomide, GBM remains an incurable and devastating disease with the median survival time rarely exceeding 14 months following diagnosis and with less than 5% of GBM patients surviving more than 3 years following diagnosis (3)(4)(5). Gliosarcoma is a rare variant of malignant glioma that is very similar to GBM in terms of genetic changes, clinical presentation and poor prognosis (6,7).…”