title: Has the survival of patients with glioblastoma changed over the years?
abstract: Over the last decade, the approach to the management of brain tumours and the understanding of glioblastoma tumour biology has advanced and a number of therapeutic interventions have evolved, some of which have shown statistically significant effects on overall survival (OS) and progression-free survival in glioblastoma. The aim of this study is to compare survival in glioblastoma patients over a 10-year period (1999-2000 and 2009-2010).
  
  
  
  A retrospective cohort study was performed. Identification of all histologically confirmed glioblastoma in a single centre in years 1999, 2000, 2009 and 2010, and production of survival analysis comparing 1999-2000 and 2009-2010 were achieved.
  
  
  
  A total of 317 patients were included in the analysis (133 in year 1999-2000, and 184 in year 2009-2010). Cox regression analysis showed that the survival was significantly longer in patients in years 2009-2010 than those in 1999-2000 at P<0.001 with HR=0.56, confidence interval (CI) (0.45-0.71). The 1- and 3-year survival rates were 20.7% and 4.4%, respectively, for patients in 1999-2000, improving to 40.0% and 10.3%, respectively, for patients in 2009-2010. The comparisons between the two groups in survival at 1, 2 and 3 years are all statistically significant at P<0.001, respectively. The median OS was 0.36 and 0.74 in 1999-2000 and 2009-2010 groups, respectively.
  
  
  
  Over this period, OS from glioblastoma has increased significantly in our unit. We believe this is due to the institution of evidence-based surgical and oncological strategies practised in a multidisciplinary setting.
authors.affiliation: Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: deSouza
authors.affiliation: Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: H
authors.initials: H
authors.lastname: Shaweis
authors.affiliation: Medical Statistics, Department of Oncology, University of Oxford, Cancer and Haematology Centre, Churchill Hospital, Oxford OX3 7LE, UK.
authors.forename: C
authors.initials: C
authors.lastname: Han
authors.affiliation: Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: V
authors.initials: V
authors.lastname: Sivasubramaniam
authors.affiliation: Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK.
authors.forename: L
authors.initials: L
authors.lastname: Brazil
authors.affiliation: Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK.
authors.forename: R
authors.initials: R
authors.lastname: Beaney
authors.affiliation: Department of Clinical Oncology, Kent Oncology Centre, Maidstone and Tunbridge Wells NHS Trust, Hermitage Lane, Maidstone, Kent ME16 9QQ, UK.
authors.forename: G
authors.initials: G
authors.lastname: Sadler
authors.affiliation: Department of Neuropathology, King's college Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: S
authors.initials: S
authors.lastname: Al-Sarraj
authors.affiliation: Department of Neuroradiology, King's college Hospital, Denmark Hill, London SE5 9RS.
authors.forename: T
authors.initials: T
authors.lastname: Hampton
authors.affiliation: Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: J
authors.initials: J
authors.lastname: Logan
authors.affiliation: Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: V
authors.initials: V
authors.lastname: Hurwitz
authors.affiliation: Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: R
authors.initials: R
authors.lastname: Bhangoo
authors.affiliation: Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: R
authors.initials: R
authors.lastname: Gullan
authors.affiliation: Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: K
authors.initials: K
authors.lastname: Ashkan
mesh_terms: D001932:Brain Neoplasms / Q000401:mortality*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends