title: Adult cerebellar glioblastoma: understanding survival and prognostic factors using a population-based database from 1973 to 2009.
abstract: OBJECTIVE
  Glioblastoma (GB) is rarely found in the cerebellum. Because of its rarity, it is poorly understood if cerebellar GB (CGB) behaves similarly to supratentorial GB. Studies have been limited to case reports and small case series. A better understanding of CGB may help guide treatment strategies.
  
  
  METHODS
  Surveillance, Epidemiology and End Results database was analyzed from 1973 to 2009 for all adult patients with GB located in the cerebellum. Stepwise multivariate proportional hazards regression analyses were used to identify factors independently associated with survival.
  
  
  RESULTS
  Two hundred eight (0.9%) patients with CGB were identified from 23,329 GB patients with known locality. The mean age was 58 years. Median survival was 8 months, with 1-, 2- and 5-year survival rates of 21%, 13%, and 2%. When compared to supratentorial GB, CGB occurred in younger patients (58 ± 16 vs. 61 ± 13 years, P = 0.001), less commonly in Whites (85.6% vs. 91.3%, P = 0.005), and were smaller (3.7 ± 1.1 vs. 4.5 ± 1.7 cm, P = 0.001). A cerebellar location independently predicted poorer survival when compared to other GB locations (P = 0.048). In multivariate analysis for patients with CGB, younger age (P < 0.001), Asian or Pacific Islander race (P = 0.046), and radiation therapy (P < 0.001) were independently associated with prolonged survival.
  
  
  CONCLUSIONS
  CGBs are difficult to analyze using institutional series because of their rarity. This study shows they are clinically different from supratentorial GB. Among patients with CGB, radiation therapy may prolong survival. This may help guide treatment strategies aimed at prolonging survival for patients with these extremely rare lesions.
authors: Department of Neurosurgery and Oncology, Neuro-Oncology Surgical Outcomes Research Laboratory, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors: Hadie
authors: H
authors: Adams
authors: Kaisorn L
authors: KL
authors: Chaichana
authors: Javier
authors: J
authors: Avendaño
authors: Brian
authors: B
authors: Liu
authors: Shaan M
authors: SM
authors: Raza
authors: Alfredo
authors: A
authors: Quiñones-Hinojosa
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002528:Cerebellar Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D003131:Combined Modality Therapy; D016208:Databases, Factual; D005006:Ethnicity; D005260:Female; D005909:Glioblastoma / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011153:Population; D011379:Prognosis; D011878:Radiotherapy; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: CGB; Cerebellar; Cerebellar glioblastoma; Cerebellum; GB; GTR; Glioblastoma; Glioma; Gross total resection; ICD-O; International Classification of Disease for Oncology; SEER; STGB; Supratentorial glioblastoma; Surveillance, Epidemiology and End Results; Survival
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