Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma

Abstract The prognostic factors and optimal treatment for the elderly patient with glioblastoma (GBM) were poorly understood. This study extracted 4975 elderly patients (≥ 65 years old) with histologically confirmed GBM from Surveillance, Epidemiology and End Results (SEER) database. Firstly, Cumula...

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Autores principales:	Zhuo-yi Liu, Song-shan Feng, Yi-hao Zhang, Li-yang Zhang, Sheng-chao Xu, Jing Li, Hui Cao, Jun Huang, Fan Fan, Li Cheng, Jun-yi Jiang, Quan Cheng, Zhi-xiong Liu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9139eac8a3b14c36bff8bb5a777559a9
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spelling	oai:doaj.org-article:9139eac8a3b14c36bff8bb5a777559a92021-12-02T16:55:24ZCompeting risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma10.1038/s41598-021-88820-52045-2322https://doaj.org/article/9139eac8a3b14c36bff8bb5a777559a92021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88820-5https://doaj.org/toc/2045-2322Abstract The prognostic factors and optimal treatment for the elderly patient with glioblastoma (GBM) were poorly understood. This study extracted 4975 elderly patients (≥ 65 years old) with histologically confirmed GBM from Surveillance, Epidemiology and End Results (SEER) database. Firstly, Cumulative incidence function and cox proportional model were utilized to illustrate the interference of non-GBM related mortality in our cohort. Then, the Fine-Gray competing risk model was applied to determine the prognostic factors for GBM related mortality. Age ≥ 75 years old, white race, size > 5.4 cm, frontal lobe tumor, and overlapping lesion were independently associated with more GBM related death, while Gross total resection (GTR) (HR 0.87, 95%CI 0.80–0.94, P = 0.010), radiotherapy (HR 0.64, 95%CI 0.55–0.74, P < 0.001), chemotherapy (HR 0.72, 95%CI 0.59–0.90, P = 0.003), and chemoRT (HR 0.43, 95%CI 0.38–0.48, P < 0.001) were identified as independently protective factors of GBM related death. Based on this, a corresponding nomogram was conducted to predict 3-, 6- and 12-month GBM related mortality, the C-index of which were 0.763, 0.718, and 0.694 respectively. The calibration curve showed that there was a good consistency between the predicted and the actual mortality probability. Concerning treatment options, GTR followed by chemoRT is suggested as optimal treatment. Radiotherapy and chemotherapy alone also provide moderate clinical benefits.Zhuo-yi LiuSong-shan FengYi-hao ZhangLi-yang ZhangSheng-chao XuJing LiHui CaoJun HuangFan FanLi ChengJun-yi JiangQuan ChengZhi-xiong LiuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Zhuo-yi Liu Song-shan Feng Yi-hao Zhang Li-yang Zhang Sheng-chao Xu Jing Li Hui Cao Jun Huang Fan Fan Li Cheng Jun-yi Jiang Quan Cheng Zhi-xiong Liu Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma
description	Abstract The prognostic factors and optimal treatment for the elderly patient with glioblastoma (GBM) were poorly understood. This study extracted 4975 elderly patients (≥ 65 years old) with histologically confirmed GBM from Surveillance, Epidemiology and End Results (SEER) database. Firstly, Cumulative incidence function and cox proportional model were utilized to illustrate the interference of non-GBM related mortality in our cohort. Then, the Fine-Gray competing risk model was applied to determine the prognostic factors for GBM related mortality. Age ≥ 75 years old, white race, size > 5.4 cm, frontal lobe tumor, and overlapping lesion were independently associated with more GBM related death, while Gross total resection (GTR) (HR 0.87, 95%CI 0.80–0.94, P = 0.010), radiotherapy (HR 0.64, 95%CI 0.55–0.74, P < 0.001), chemotherapy (HR 0.72, 95%CI 0.59–0.90, P = 0.003), and chemoRT (HR 0.43, 95%CI 0.38–0.48, P < 0.001) were identified as independently protective factors of GBM related death. Based on this, a corresponding nomogram was conducted to predict 3-, 6- and 12-month GBM related mortality, the C-index of which were 0.763, 0.718, and 0.694 respectively. The calibration curve showed that there was a good consistency between the predicted and the actual mortality probability. Concerning treatment options, GTR followed by chemoRT is suggested as optimal treatment. Radiotherapy and chemotherapy alone also provide moderate clinical benefits.
format	article
author	Zhuo-yi Liu Song-shan Feng Yi-hao Zhang Li-yang Zhang Sheng-chao Xu Jing Li Hui Cao Jun Huang Fan Fan Li Cheng Jun-yi Jiang Quan Cheng Zhi-xiong Liu
author_facet	Zhuo-yi Liu Song-shan Feng Yi-hao Zhang Li-yang Zhang Sheng-chao Xu Jing Li Hui Cao Jun Huang Fan Fan Li Cheng Jun-yi Jiang Quan Cheng Zhi-xiong Liu
author_sort	Zhuo-yi Liu
title	Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma
title_short	Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma
title_full	Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma
title_fullStr	Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma
title_full_unstemmed	Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma
title_sort	competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9139eac8a3b14c36bff8bb5a777559a9
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Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma

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