Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database

Background: Glioblastoma (GBM) is the most common primary intracranial malignancy. Previous studies found incidence of GBM varies substantially by age, sex, race and ethnicity, and survival also varies by country, ethnicity, and treatment. Gliosarcoma (GSM) and giant cell glioblastoma (GC-GBM) are d...

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Autores principales:	Li-Tsun Shieh, Chung-Han Ho, How-Ran Guo, Chien-Cheng Huang, Yi-Chia Ho, Sheng-Yow Ho
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	glioblastoma gliosarcoma giant cell glioblastoma histologic variant epidemiology Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/65b20fc09c354a168ca63446b3744603
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spelling	oai:doaj.org-article:65b20fc09c354a168ca63446b37446032021-11-30T15:36:24ZEpidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database1664-229510.3389/fneur.2021.659921https://doaj.org/article/65b20fc09c354a168ca63446b37446032021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.659921/fullhttps://doaj.org/toc/1664-2295Background: Glioblastoma (GBM) is the most common primary intracranial malignancy. Previous studies found incidence of GBM varies substantially by age, sex, race and ethnicity, and survival also varies by country, ethnicity, and treatment. Gliosarcoma (GSM) and giant cell glioblastoma (GC-GBM) are different histologic variants of GBM with distinct clinico-pathologic entities. We conducted a study to compare epidemiology, survival, and prognostic factors among the three.Methods: We identified GBM patients diagnosed between 2000 and 2016 using the Taiwan Cancer Registry and followed them using the death registry. Survival was compared among conventional GBM and two histologic variants. The potential confounding factors evaluated in this study included registered year, age, sex, and treatment modality (resection, radiotherapy, and chemotherapy).Results: We enrolled 3,895 patients, including 3,732 (95.8%) with conventional GBM, 102 (2.6%) with GSM, and 61 (1.6%) with GC-GBM. GC-GBM patients had younger mean age at diagnosis (49.5 years) than conventional GBM patients (58.7 years) and GSM patients (61.3 years) (p < 0.01). The three groups had similar sex distributions (p = 0.29). GC-GBM had a longer median survival [18.5, 95% confidence interval (CI): 15.8–25.3 months] than conventional GBM (12.5, 95%CI: 12.0–13.0 months) and GSM (12.8, 95%CI: 9.2–16.2 months), and the differences in overall survival did not attain statistical significance (p = 0.08, log-rank test). In univariate analysis, GC-GBM had better survival than conventional GBM, but the hazard ratio (0.91) did not reach statistical significance (95%CI: 0.69–1.20) in the multivariate analysis. Young ages (≤ 40 years), female sex, resection, radiotherapy, and chemotherapy were factors associated with better survival in overall GBMs. In subtype analyses, these factors remained statistically significant for conventional GBM, as well as radiotherapy for GSM.Conclusion: Our analysis found conventional GBM and its variants shared similar poor survival. Factors with age ≤ 40 years, female sex, resection, radiotherapy, and chemotherapy were associated with better prognosis in conventional GBM patients.Li-Tsun ShiehChung-Han HoChung-Han HoHow-Ran GuoHow-Ran GuoChien-Cheng HuangChien-Cheng HuangYi-Chia HoSheng-Yow HoSheng-Yow HoSheng-Yow HoFrontiers Media S.A.articleglioblastomagliosarcomagiant cell glioblastomahistologic variantepidemiologyNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	glioblastoma gliosarcoma giant cell glioblastoma histologic variant epidemiology Neurology. Diseases of the nervous system RC346-429
spellingShingle	glioblastoma gliosarcoma giant cell glioblastoma histologic variant epidemiology Neurology. Diseases of the nervous system RC346-429 Li-Tsun Shieh Chung-Han Ho Chung-Han Ho How-Ran Guo How-Ran Guo Chien-Cheng Huang Chien-Cheng Huang Yi-Chia Ho Sheng-Yow Ho Sheng-Yow Ho Sheng-Yow Ho Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database
description	Background: Glioblastoma (GBM) is the most common primary intracranial malignancy. Previous studies found incidence of GBM varies substantially by age, sex, race and ethnicity, and survival also varies by country, ethnicity, and treatment. Gliosarcoma (GSM) and giant cell glioblastoma (GC-GBM) are different histologic variants of GBM with distinct clinico-pathologic entities. We conducted a study to compare epidemiology, survival, and prognostic factors among the three.Methods: We identified GBM patients diagnosed between 2000 and 2016 using the Taiwan Cancer Registry and followed them using the death registry. Survival was compared among conventional GBM and two histologic variants. The potential confounding factors evaluated in this study included registered year, age, sex, and treatment modality (resection, radiotherapy, and chemotherapy).Results: We enrolled 3,895 patients, including 3,732 (95.8%) with conventional GBM, 102 (2.6%) with GSM, and 61 (1.6%) with GC-GBM. GC-GBM patients had younger mean age at diagnosis (49.5 years) than conventional GBM patients (58.7 years) and GSM patients (61.3 years) (p < 0.01). The three groups had similar sex distributions (p = 0.29). GC-GBM had a longer median survival [18.5, 95% confidence interval (CI): 15.8–25.3 months] than conventional GBM (12.5, 95%CI: 12.0–13.0 months) and GSM (12.8, 95%CI: 9.2–16.2 months), and the differences in overall survival did not attain statistical significance (p = 0.08, log-rank test). In univariate analysis, GC-GBM had better survival than conventional GBM, but the hazard ratio (0.91) did not reach statistical significance (95%CI: 0.69–1.20) in the multivariate analysis. Young ages (≤ 40 years), female sex, resection, radiotherapy, and chemotherapy were factors associated with better survival in overall GBMs. In subtype analyses, these factors remained statistically significant for conventional GBM, as well as radiotherapy for GSM.Conclusion: Our analysis found conventional GBM and its variants shared similar poor survival. Factors with age ≤ 40 years, female sex, resection, radiotherapy, and chemotherapy were associated with better prognosis in conventional GBM patients.
format	article
author	Li-Tsun Shieh Chung-Han Ho Chung-Han Ho How-Ran Guo How-Ran Guo Chien-Cheng Huang Chien-Cheng Huang Yi-Chia Ho Sheng-Yow Ho Sheng-Yow Ho Sheng-Yow Ho
author_facet	Li-Tsun Shieh Chung-Han Ho Chung-Han Ho How-Ran Guo How-Ran Guo Chien-Cheng Huang Chien-Cheng Huang Yi-Chia Ho Sheng-Yow Ho Sheng-Yow Ho Sheng-Yow Ho
author_sort	Li-Tsun Shieh
title	Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database
title_short	Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database
title_full	Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database
title_fullStr	Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database
title_full_unstemmed	Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database
title_sort	epidemiologic features, survival, and prognostic factors among patients with different histologic variants of glioblastoma: analysis of a nationwide database
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/65b20fc09c354a168ca63446b3744603
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Epidemiologic Features, Survival, and Prognostic Factors Among Patients With Different Histologic Variants of Glioblastoma: Analysis of a Nationwide Database

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