Original Article

Which glioblastoma multiforme patient will become a long-term survivor? A population-based study

  1. J. N. Scott MD1,7,
  2. N. B. Rewcastle MD2,7,
  3. P. M. A. Brasher PhD4,
  4. D. Fulton MD8,9,
  5. J. A. MacKinnon MD5,
  6. M. Hamilton MD3,6,7,
  7. J. G. Cairncross MD10,
  8. P. Forsyth MD3,6,7,*

Article first published online: 22 MAY 2001

DOI: 10.1002/1531-8249(199908)46:2<183::AID-ANA7>3.0.CO;2-7

Issue

Annals of Neurology

Annals of Neurology

Volume 46, Issue 2, pages 183–188, August 1999

Additional Information

How to Cite

Scott, J. N., Rewcastle, N. B., Brasher, P. M. A., Fulton, D., MacKinnon, J. A., Hamilton, M., Cairncross, J. G. and Forsyth, P. (1999), Which glioblastoma multiforme patient will become a long-term survivor? A population-based study. Ann Neurol., 46: 183–188. doi: 10.1002/1531-8249(199908)46:2<183::AID-ANA7>3.0.CO;2-7

Author Information

  1. 1

    Department of Diagnostic Imaging, University of Calgary, Calgary, Canada

  2. 2

    Department of Pathology and Clinical Neurosciences, University of Calgary, Calgary, Canada

  3. 3

    Department of Clinical Neurosciences and Pediatrics, University of Calgary, Calgary, Canada

  4. 4

    Department of Epidemiology, Prevention and Screening, Alberta Cancer Board and Community Health Sciences, University of Calgary, Calgary, Canada

  5. 5

    Department of Radiation Oncology, University of Calgary, Calgary, Canada

  6. 6

    Tom Baker Cancer Centre (TBCC), University of Calgary, Calgary, Canada

  7. 7

    Department of Medicine, Foothills Hospital, Calgary, Canada

  8. 8

    Department of Radiation Oncology, Cross Cancer Institute (CCI), University of Alberta, Edmonton, Alberta, Canada

  9. 9

    Department of Medicine/Neurology, University of Alberta, Edmonton, Alberta, Canada

  10. 10

    Clinical Neurological Sciences and Oncology, University of Western Ontario and London Regional Cancer Centre, London, Ontario, Canada

*Department of Medicine, Tom Baker Cancer Centre, 1331 29 St NW, Calgary, Alberta, Canada T2N 4N2

Publication History

  1. Issue published online: 22 MAY 2001
  2. Article first published online: 22 MAY 2001
  3. Manuscript Accepted: 5 MAR 1999
  4. Manuscript Revised: 4 MAR 1999
  5. Manuscript Received: 8 OCT 1998

Funded by

  • Alberta Cancer Board

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Abstract

In this clinical and histopathological study, the frequency of long-term glioblastoma multiforme (GBM) survivors (LTGBMSs) was determined in a population-based study. The Alberta Cancer Registry was used to identify all patients diagnosed with GBM in Alberta between January 1, 1975, and December 31, 1991. Patient charts were reviewed and histology reexamined. LTGBMSs were defined as GBM patients surviving 3 years after diagnosis. Each LTGBMS was compared with 3 age-, sex-, and year of diagnosis–matched controls, and patient/treatment or tumor characteristics that predicted long-term survival were determined. There were 689 GBMs diagnosed in the study period; 15 (2.2%) of these patients survived 3 years. LTGBMSs (average age, 43.5 ± 3.3 years) were significantly younger when compared with all GBM patients (average age, 53.0 ± 0.56 years). LTGBMSs had a higher Karnofsky Performance Status score at diagnosis compared with controls. LTGBMSs were much more likely to have had a gross total resection and adjuvant chemotherapy than control GBM patients. Tumors from LTGBMSs tended to have fewer mitoses and a significantly lower Ki-67 cellular proliferation index compared with controls. Radiation-induced dementia was common and disabling in LTGBMSs. In conclusion, conventionally treated GBM patients in an unselected population have a very small chance of long-term survival. The use of aggressive surgical resection and adjuvant chemotherapy may make long-term survival more likely in GBM patients if their performance status is high at diagnosis. Ann Neurol 1999;47:183–188

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