Abstract
Purpose
To comprehensively analyze the impact of surgical compliance on the survival of patients with glioma and to explore the factors that influence surgical compliance.
Methods
Clinical data of patients with glioma between 2004 and 2018 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan–Meier curves and Cox regression were used to analyze the effect of surgical compliance on overall survival (OS) and disease-specific survival (DSS). Multivariate Cox regression was used to select the prediction variables and construct the nomograms. The predictive power of these models was assessed using Harell’s consistency index (C-index), decision curve analysis (DCA), receiver operating characteristic (ROC) curves, and calibration curves. Multivariate logistic regression was performed to analyze the related variables of surgical compliance, and 1:1 propensity score matching (PSM) was applied to evaluate the validity of the results of patients with favorable and poor surgical compliance.
Results
Among the 47,573 eligible glioma patients recommended for surgery, 46,380 (97.5%) were in the surgical compliance group, while 1193 (2.5%) were in the noncompliance group. Surgical compliance was an independent prognostic factor for glioma patients, as indicated by multivariate Cox regression analysis that patients with surgical compliance had worse OS (hazard ratio [HR] 1.924; 95% confidence interval [CI] 1.800–2.056, p < 0.001) and DSS (HR 1.718; 95% CI 1.592–1.853, p < 0.001) in comparison to those without surgical compliance. A nomogram was developed and internally validated to be able to predict glioma prognosis. The nomogram can well predict patients’ OS (C-index: 0.745) and DSS (C-index: 0.744). ROC curve, DCA curve, and calibration curve were applied to further assess the accuracy of the nomogram. Poor surgical compliance was found to be related to older age, female gender, tumor diameter, grade II or higher, poor grading, tumor location in the cerebellum and brainstem, and low household income.
Conclusion
Surgical compliance is an independent prognostic factor for predicting the OS and DSS of patients with glioma, and good surgical compliance was significantly related to good survival.
Similar content being viewed by others
Data availability
The dataset for the current study is available from the corresponding author upon reasonable request.
References
Adesunkanmi AR, Lawal OO, Adelusola KA, Durosimi MA (2006) The severity, outcome and challenges of breast cancer in Nigeria. Breast 15(3):399–409
Allen JC, Siffert J, Hukin J (1998) Clinical manifestations of childhood ependymoma: a multitude of syndromes. Pediatr Neurosurg 28(1):49–55
Benesch M, Mynarek M, Witt H, Warmuth-Metz M, Pietsch T, Bison B, Pfister SM, Pajtler KW, Kool M, Schüller U, Pietschmann K, Juhnke BO, Tippelt S, Fleischhack G, Schmid I, Kramm CM, Vorwerk P, Beilken A, Classen CF, Hernáiz Driever P, Kropshofer G, Imschweiler T, Lemmer A, Kortmann RD, Rutkowski S, von Hoff K (2019) Newly diagnosed metastatic intracranial ependymoma in children: frequency, molecular characteristics, treatment, and outcome in the prospective HIT series. Oncologist 24(9):e921–e929
Dearden L, Bouret SG, Ozanne SE (2018) Sex and gender differences in developmental programming of metabolism. Mol Metab 15:8–19
Doll KM, Rademaker A, Sosa JA (2018) Practical guide to surgical data sets: surveillance, epidemiology, and end results (SEER) database. JAMA Surg 153(6):588–589
Hou Z, Luo D, Luo H, Hui Q, Xu Y, Lin X, Xu Z (2023) Co-expression prognostic-related genes signature base on propofol and sevoflurane anesthesia predict prognosis and immunotherapy response in glioblastoma. Ann Med 55(1):778–792
Jakola AS, Myrmel KS, Kloster R, Torp SH, Lindal S, Unsgård G et al (2012) Comparison of a strategy favoring early surgical resection versus a strategy favoring watchful waiting in low-grade gliomas. JAMA 308:1881–1888
Kiserud T, Benachi A, Hecher K et al (2018) The World Health Organization fetal growth charts: concept, findings, interpretation, and application. Am J Obstet Gynecol 218(2S):S619–S629
Lah TT, Novak M, Breznik B (2020) Brain malignancies: glioblastoma and brain metastases. Semin Cancer Biol 60:262–273
Liu G, Xu M, Gao T, Xu L, Zeng P, Bo H, Li F, Zhang W, Wang Z (2019) Surgical Compliance and Outcomes in Gastric Cancer: a population-based cohort study. J Cancer 10(4):779–788
Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, Hawkins C, Ng HK, Pfister SM, Reifenberger G, Soffietti R, von Deimling A, Ellison DW (2021) The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro Oncol 23(8):1231–1251
Luo J, Pan M, Mo K, Mao Y, Zou D (2023) Emerging role of artificial intelligence in diagnosis, classification and clinical management of glioma. Semin Cancer Biol 91:110–123
Ma R, Taphoorn MJB, Plaha P (2021) Advances in the management of glioblastoma. J Neurol Neurosurg Psychiatry 92(10):1103–1111
McKinnon C, Nandhabalan M, Murray SA et al (2021) Glioblastoma: clinical presentation, diagnosis, and management. BMJ 374:n1560
Montero D, Madsen K, Meinild-Lundby AK, Edin F, Lundby C (2018) Sexual dimorphism of substrate utilization: differences in skeletal muscle mitochondrial volume density and function. Exp Physiol 103(6):851–859
Olubajo F, Thorpe A, Davis C, Sinha R, Crofton A, Mills SJ, Williams M, Jenkinson MD, Price SJ, Watts C, Brodbelt AR (2022) Tumour treating fields in glioblastoma: is the treatment tolerable, effective, and practical in UK patients? Br J Neurosurg 36(6):770–776
Onken J, Staub-Bartelt F, Vajkoczy P, Misch M (2018) Acceptance and compliance of TTFields treatment among high grade glioma patients. J Neurooncol 139(1):177–184
Ostrom QT, Bauchet L, Davis FG, Deltour I, Fisher JL, Langer CE, Pekmezci M, Schwartzbaum JA, Turner MC, Walsh KM, Wrensch MR, Barnholtz-Sloan JS (2014) The epidemiology of glioma in adults: a “state of the science” review. Neuro Oncol 16(7):896–913
Ostrom QT, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS (2016) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2013–2017. Neuro Oncol. https://doi.org/10.1093/neuonc/now207
Ou A, Yung WKA, Majd N (2020) Molecular mechanisms of treatment resistance in glioblastoma. Int J Mol Sci 22(1):351
Rigamonti A, Simonetti G, Silvani A et al (2021) Adult brainstem glioma: a multicentre retrospective analysis of 47 Italian patients. Neurol Sci 42(5):1879–1886
Shan Y, Ding Z, Cui Z, Chen A (2023) Incidence, prognostic factors and a nomogram of cervical cancer with distant organ metastasis: a SEER-based study. J Obstet Gynaecol 43(1):2181690
Stessin AM, Sherr DL (2011) Demographic disparities in patterns of care and survival outcomes for patients with resected gastric adenocarcinoma. Cancer Epidemiol Biomarkers Prev 20:223–233
Tavallaii A, Meybodi KT, Nejat F, Habibi Z (2023) Current status of research on targeted therapy against central nervous system tumors in low- and lower-middle-income countries. World Neurosurg 12(174):74–80
Wang S, Mao W, Wang Y, Shi X, Wang W, Dai L, Zhang W (2020) Surgical compliance and survival outcomes for patients with stage T1–2 non-small-cell lung cancer. Cancer Manag Res 19(12):3597–3610
Wang K, Gu Y, Ni J, Zhang H, Xie J, Xu T, Geng J, Mao W, Peng B (2021) Combination of total psoas index and albumin-globulin score for the prognosis prediction of bladder cancer patients after radical cystectomy: a population-based study. Front Oncol 11:724536
Wang GM, Cioffi G, Patil N, Waite KA, Lanese R, Ostrom QT, Kruchko C, Berens ME, Connor JR, Lathia JD, Rubin JB, Barnholtz-Sloan JS (2022) Importance of the intersection of age and sex to understand variation in incidence and survival for primary malignant gliomas. Neuro Oncol 24(2):302–310
Withrow DR, Nicholson BD, Morris EJA, Wong ML, Pilleron S (2023) Age-related differences in cancer relative survival in the United States: a SEER-18 analysis. Int J Cancer 152(11):2283–2291
Yang P, Wang Y, Peng X, You G, Zhang W, Yan W et al (2013) Management and survival rates in patients with glioma in China (2004–2010): a retrospective study from a single-institution. J Neuro-Oncol 113(2):259–266
Yang Z, Zhao C, Zong S, Piao J, Zhao Y, Chen X (2023) A review on surgical treatment options in gliomas. Front Oncol 16(13):1088484
Zhang D, Li H, Jia W (2023) Exploration of the prognostic value of the resection of adult brainstem high-grade glioma based on competing risk model, propensity score matching, and conditional survival rate. Neurol Sci 44(5):1755–1764
Zheng BS, Wang SD, Zhang JY, Ge CG (2023) Incidence, prognostic factors, and survival of patients with renal cancer: a population-based study. J Invest Surg 36(1):2197506
Zore T, Palafox M, Reue K (2018) Sex differences in obesity, lipid metabolism, and inflammation-A role for the sex chromosomes? Mol Metab 15:35–44
Acknowledgements
The authors are very grateful for the efforts of the SEER (Surveillance, Epidemiology, and End Results) Program tumor registry in creating the SEER database.
Author information
Authors and Affiliations
Contributions
AHE and AHZ: Conceptualization, methodology, software, writing-manuscript, writing-review, and editing. XY, YC and LX: software, visualization, data management and formal analysis. AHE and ZG: Writing, review, and editing. LX and XY: Conceptualization, supervision, project management, writing, review, and editing. HZ: Revision. All authors contributed to this article and approved the submitted version.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare there are no potential conflicts of interest related to this study.
Ethical statement
This study used publicly available SEER cancer registry data rather than the human subject study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
He, A., Xu, L., Yang, X. et al. Risk factors for surgical compliance and impact on the survival of patients with glioma: a population-based propensity score-matched study. J Cancer Res Clin Oncol 149, 14797–14815 (2023). https://doi.org/10.1007/s00432-023-05261-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00432-023-05261-5