Age as an independent prognostic factor in patients with glioblastoma: a radiation therapy oncology group and American College of Surgeons National Cancer Data Base comparison
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Glioblastoma (GBM) is rare in early adulthood and little information is available on this subgroup. We investigated whether young age (18–30 years) had an independent effect on survival. We retrospectively reviewed patients from two large databases: Radiation Therapy Oncology Group (RTOG) and American College of Surgeons National Cancer Data Base (NCDB). In the RTOG evaluation, we analyzed all eligible GBM cases from 17 RTOG studies from 1974 to 2002. All patients with GBM during 1985–1998 in the NCDB were examined for comparison. Patients were divided into three cohorts: ages 18–30, 31–49, and ≥50. Overall survival, as a function of age (discreet and continuous), was assessed. The RTOG review included 3,136 patients: 112 (3.6%) were 18–30, 780 (24.9%) were 31–49, and 2,244 (71.6%) were ≥50. The median survival times of the three groups were 21.0, 13.5, and 9.1 months (P < 0.0001). Significant improvement in survival for younger patients was demonstrated with adjustment for recursive partitioning analysis (RPA) class. Of the 37,260 patients analyzed in the NCDB, 796 (2.1%) were 18–30, 5,711 (15.3%) were 31–49, and 30,753 (82.5%) were ≥50. The median survival times of the three groups were 18.0, 12.8, and 6.3 months (P < 0.0001). Data were not available for RPA class from this series. GBM is rare in young adulthood, comprising 2.1–3.6% of our patients. They have superior survival, even when adjusted for RPA class. More investigations on the unique biologic and clinical characteristics of tumors in this population are needed.
KeywordsGlioblastoma Young adult Age factors Prognostic factors Survival
Supported by RTOG U10 CA21661, CCOP U10 CA37422, and Stat U10 CA32115 grants from the National Cancer Institute. Also supported by Brain Tumor Funders’ Grant. This abstract’s/manuscript’s contents are the sole responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.
Conflicts of interest
Dr. Mehta has served as a consultant to Adnexus, Bayer, Genenteh, Merck, Schering Plough, and Tomotherapy; he serves on the Board of Directors of Pharmacyclics, and as an advisor to Stemina, and is on the DSMB for Apogenix. He holds stock options in Pharmacyclics and Tomotherapy. There are no other conflicts of interest to declare.
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