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Patterns of care and survival for glioblastoma patients in the Veterans population

  • Clinical Study – Patient Study
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Abstract

Survival outcomes and patterns of care for brain tumor patients in the USA Veterans population have not been previously published and the extent of variation in outcomes between Veterans and the rest of the USA is currently unknown. The Veterans healthcare administration (VA) provides comprehensive care to Veterans and their families and maintains the Veterans affairs central cancer registry (VACCR). This was a retrospective review of microscopically-confirmed, supratentorial glioblastoma multiforme in male Veterans actively followed by the VACCR; survival was analyzed and compared to a national cohort from the surveillance, epidemiology and end results program. We analyzed 1,219 Veterans with glioblastomas diagnosed between 1997 and 2006. Median survival was 6.5 months and 1, 2, and 5 years survival rates were 26.8, 5.4, and 0.5%, respectively. Patients receiving all three treatment modalities (surgical resection, radiotherapy, and chemotherapy) did best; these findings remained true among patients aged 70 and older such that these patients had an overall survival similar to those age <70. A comparable national cohort had longer median survival (9.0 months) and greater 1, 2, and 5 years survival rates (37.8, 12.8, and 4.1%) than the VA cohort. Survival and patterns of care are presented for the first time for Veterans with glioblastoma multiforme. In conclusion, we found that more aggressive therapy was associated with better survival, even among elderly Veterans and whether compared overall or by age group, VA patients showed decreased survival relative to a national cohort. We believe this potential disparity warrants further investigation.

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Authors and Affiliations

  1. Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Robert T. Arrigo

  2. Outcomes Research Lab, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA

    Robert T. Arrigo, Maxwell Boakye & Stephen L. Skirboll

  3. Center for Advanced Neurosurgery, University of Louisville, 220 Abraham Flexner Way, Ste 1105, Louisville, KY, 40202, USA

    Maxwell Boakye

  4. Department of Neurosurgery, Stanford University Medical Center, 3801 Miranda Ave, M-112, Palo Alto, CA, 94304, USA

    Stephen L. Skirboll

  5. Section of Neurosurgery, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA

    Stephen L. Skirboll

Authors
  1. Robert T. Arrigo
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  2. Maxwell Boakye
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  3. Stephen L. Skirboll
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Correspondence to Maxwell Boakye.

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Arrigo, R.T., Boakye, M. & Skirboll, S.L. Patterns of care and survival for glioblastoma patients in the Veterans population. J Neurooncol 106, 627–635 (2012). https://doi.org/10.1007/s11060-011-0702-6

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  • DOI: https://doi.org/10.1007/s11060-011-0702-6

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