Oncological patterns of care and outcome for 952 patients with newly diagnosed glioblastoma in 2004.
This report, an audit requested by the French government, describes oncological patterns of care, prognostic factors, and survival for patients with newly diagnosed and histologically confirmed glioblastoma multiforme (GBM) in France. The French Brain Tumor DataBase, which is a national multidisciplinary (neurosurgeons, neuropathologists, radiotherapists, neurooncologists, epidemiologists, and biostatisticians) network, prospectively collected initial data for the cases of GBM in 2004, and a specific data card was used to retrospectively collect data on the management and follow-up care of these patients between January 1, 2004, and December 1, 2006. We recorded 952 cases of GBM (male/female ratio 1.6, median age 63.9 years, mean preoperative Karnofsky performance status [KPS] 79). Surgery consisted of resection (RS; n = 541) and biopsy (n = 411); 180 patients did not have subsequent oncological treatment. After surgery, first-line treatment (n = 772) consisted of radiotherapy (RT) and temozolomide (TMZ) concomitant +/- adjuvant in 314 patients, RT alone in 236 patients, chemotherapy (CT) alone in 157 patients, and other treatment modalities in 65 patients. Median overall survival was 286 days (95% CI, 266-314) and was significantly affected by age, KPS, and tumor location. Median survival (days, 95% CI) associated with these main strategies, when analyzed by a surgical group, were as follows: RS + RT-TMZ((n=224)): 476 (441-506), biopsy + RT-TMZ((n=90)): 329 (301-413), RS + RT((n=147)): 363 (331-431), biopsy + RT((n=89)): 178 (153-237), RS + CT((n=61)): 245 (190-361), biopsy + CT((n=96)): 244 (198-280), and biopsy only((n=118)): 55 (46-71). This study illustrates the usefulness of a national brain tumor database. To our knowledge, this work is the largest report of recent GBM management in Europe.
Bauchet
Luc
L
Department of Neurosurgery, Hospital Gui de Chauliac, CHU Montpellier, 80 avenue A. Fliche, 34295 Montpellier cedex 5, France. l-bauchet@chu-montpellier.fr
Mathieu-Daudé
Hélène
H
Fabbro-Peray
Pascale
P
Rigau
Valérie
V
Fabbro
Michel
M
Chinot
Olivier
O
Pallusseau
Loreleï
L
Carnin
Charlotte
C
Lainé
Karl
K
Schlama
Aline
A
Thiebaut
Agnes
A
Patru
Maria Cristina
MC
Bauchet
Fabienne
F
Lionnet
Martine
M
Wager
Michel
M
Faillot
Thierry
T
Taillandier
Luc
L
Figarella-Branger
Dominique
D
Capelle
Laurent
L
Loiseau
Hugues
H
Frappaz
Didier
D
Campello
Chantal
C
Kerr
Christine
C
Duffau
Hugues
H
Reme-Saumon
Monique
M
Trétarre
Brigitte
B
Daures
Jean-Pierre
JP
Henin
Dominique
D
Labrousse
François
F
Menei
Philippe
P
Honnorat
Jérome
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005602:France / Q000453:epidemiology; D005909:Glioblastoma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D058028:Research Report / Q000592:standards*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult