Survival trends in glioblastoma and association with treating facility volume

Publication date: Available online 24 May 2019Source: Journal of Clinical NeuroscienceAuthor(s): Sonikpreet Aulakh, Michelle R. DeDeo, Joseph Free, Steven S. Rosenfeld, Alfredo Quinones-Hinojosa, Aneel Paulus, Alak Manna, Rami Manochakian, Asher A. Chanan-Khan, Sikander AilawadhiAbstractGlioblastoma (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;...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research