title: Effect of pretreatment clinical factors on overall survival in glioblastoma multiforme: a Surveillance Epidemiology and End Results (SEER) population analysis.
abstract: BACKGROUND
  Glioblastoma Multiforme (GBM) is one of the most aggressive primary brain tumors and is associated with a dismal prognosis. The median survival after the primary diagnosis remains poor, even after multimodal treatment approaches. However, a few patients have been reported to have long term survival greater than three years. A number of studies have attempted to define factors capable of predicting long term outcomes in specific patient groups. This article reports the outcomes of a very large group of patients diagnosed with GBM, and analyzes specific prognostic factors known to influence survival in these patients.
  
  
  METHODS
  We used the Surveillance, Epidemiology, and End Results (SEER) database of the US National Cancer Institute (NCI) to investigate various patient-related and treatment-related factors that could influence the long term survival in patients diagnosed with glioblastoma. A total of 34,664 patients aged 20 years or older with a diagnosis of GBM during the years 1973 to 2008 were studied. Overall survival outcomes were examined with Kaplan-Meier survival analysis and Cox hazard models.
  
  
  RESULTS
  Asian/Pacific Islanders had a better survival compared to the white population (P = <0.001). Patients diagnosed with GBM during the years 2000 to 2008 had a superior survival rate when compared with earlier decades (P = <0 .001). Statistically significant improvements in overall survival were also found for patients who received surgical resections, and adjuvant radiation treatment versus no radiation (P-values <0.001). Young age was also found to be highly predictive of improved overall survival rates when separated into age groups as well as when studied as a continuous variable.
  
  
  CONCLUSIONS
  Clinical pretreatment and treatment factors, including young age at diagnosis, Asian/Pacific Islander ethnicity, recent year of diagnosis, surgical resection and the use of adjuvant radiation therapy favorably influence survival in patients diagnosed with glioblastoma.
  
  
  BACKGROUND
  All data were obtained from the United States Surveillance Epidemiology and End Results (SEER) database.
authors.affiliation: The Gamma Knife of Spokane, Spokane, WA, USA.
authors.forename: Sudheer R
authors.initials: SR
authors.lastname: Thumma
authors.forename: Robert K
authors.initials: RK
authors.lastname: Fairbanks
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Lamoreaux
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Mackay
authors.forename: John J
authors.initials: JJ
authors.lastname: Demakas
authors.forename: Barton S
authors.initials: BS
authors.lastname: Cooke
authors.forename: Ameer L
authors.initials: AL
authors.lastname: Elaimy
authors.forename: Peter W
authors.initials: PW
authors.lastname: Hanson
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality* / Q000601:surgery; D015254:DNA Modification Methylases / Q000235:genetics; D045643:DNA Repair Enzymes / Q000235:genetics; D005909:Glioblastoma / Q000401:mortality* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D018426:SEER Program; D015996:Survival Rate; D025521:Tumor Suppressor Proteins / Q000235:genetics
chemical_list: D025521:Tumor Suppressor Proteins; D015254:DNA Modification Methylases; C515491:MGMT protein, human; D045643:DNA Repair Enzymes