Characteristics of long-term glioblastoma survivors diagnosed from 2010 to 2016 in the United States

Abstract

Background

Glioblastoma (GBM) is the most common malignant primary central nervous system (CNS) tumor, accounting for half (50.9 %) of all malignant tumors diagnosed in the US. We conducted a population-based analysis using Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries (NPCR) survival database investigate which patient- and tumor-level factors are characteristic of long-term survivors (LTS) of GBM.

Methods

Individual-level survival data containing diagnoses of primary GBM were obtained from the NPCR survival database for cases diagnosed during the period of January 1st, 2010 to December 31st, 2016, and followed through December 31st, 2019. Differences in LTS (>36-months) were investigated using χ² tests and multivariable logistic regression. Frequency of IDHmut-GBM by age was estimated in the same dataset from 2018 to 2021.

Results

Of the included GBM, 11.6 % met criteria for LTS. After adjustment for known prognostic factors, males (OR=0.78, p < 0.001) and age > 60 at diagnosis, were all significantly associated with decreased odds of LTS (70–79 years O =0.48, 80 + years OR=0_.21, both p < 0.001). Frequency of IDHmut-GBM peaked from 25 to 34, with < 5 % of GBM in those > 50 having IDHmut-GBM. In a sensitivity analysis in those > 50 diagnosis, both male sex and age remained significant predictors of LTS

Conclusion

There are multiple patient- and tumor-level factors that are associated with improved survival in GBM, with the strongest effect sizes in the multivariable models being due to age. These results demonstrate substantial heterogeneity in GBM prognosis and emphasize the distinct survival advantage associated with age at diagnosis.