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Survival trends in glioblastoma and association with treating facility volume.
- Source :
-
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2019 Oct; Vol. 68, pp. 271-274. Date of Electronic Publication: 2019 May 24. - Publication Year :
- 2019
-
Abstract
- Glioblastoma (GBM) is one of the most lethal cancers. Various prognostic factors impact the survival of GBM patients. To further understand this extremely poor prognosis disease, we evaluated the effect of the treatment facility volumes on overall survival (OS) over the years, especially after the approval of multimodality therapy using temozolomide (TMZ) in 2005. National Cancer Data Base (NCDB) was utilized to identify GBM cases from 2004 through 2013 using ICD-O-3 code 9440/3 to identify eligible patients. We focused on studying the association between treatment facility volume and OS after adjusting for the patient-, disease-, and facility-characteristics. A total of 60,672 eligible GBM patients with median age of 65 years, treated at 1166 facilities were included in this analysis. The median annual facility volume was 3 patients/year (range: 0.1-55.1) and median OS was 8.1 months. There was an improvement in OS across all facilities after 2005, when multimodality therapy with TMZ was approved. Treatment at quartile 4 centers (Q4; >7 patients/year) was independently associated with decreased all-cause mortality in a multivariate analysis (Q3 hazard ratio [HR]: 1.11, 95% CI 1.09, 1.13; Q2 HR: 1.15, 95% CI 1.12, 1.19; Q1 HR: 1.25, 95% CI 1.17, 1.33). Treatment facility volume independently affects OS among GBM patients. Factors that are variable in high- and low-volume centers should be addressed to mitigate outcome disparities.<br /> (Copyright © 2019 Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Antineoplastic Agents, Alkylating therapeutic use
Brain Neoplasms therapy
Databases, Factual
Female
Glioblastoma therapy
Hospitals, High-Volume statistics & numerical data
Hospitals, Low-Volume statistics & numerical data
Humans
Middle Aged
Temozolomide therapeutic use
Brain Neoplasms mortality
Combined Modality Therapy mortality
Glioblastoma mortality
Hospitals, High-Volume trends
Hospitals, Low-Volume trends
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2653
- Volume :
- 68
- Database :
- MEDLINE
- Journal :
- Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
- Publication Type :
- Academic Journal
- Accession number :
- 31133366
- Full Text :
- https://doi.org/10.1016/j.jocn.2019.04.028