Improved Glioblastoma Survival Across Sweden From 1999 to 2023: Nationwide Analysis Highlights Impact of Demographic and Prognostic Factors When Analysing Regional Variations—A Comprehensive Analysis of 7669 Glioblastoma Patients

IF 1.1 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2026-09-08 DOI:10.1155/ane/9958070

Helena K. Bruhn, Björn Tavelin, Roger Henriksson

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引用次数: 0

Abstract

Background and Purpose

Glioblastoma, the most prevalent primary malignant brain tumour, has a median survival of 9–11 months for unselected populations. This nationwide Swedish study (1999–2023) assessed survival, regional differences and their correlation to clinical prognostic factors in patients diagnosed with glioblastoma.

Patient/Material and Methods

Using the Swedish Registry for Primary Brain Tumours, 7669 patients with glioblastoma were identified. Data on overall survival (OS), relative survival (RS), age, sex, preoperative performance status (PPS), tumour size, surgical resection grade and oncological treatments were collected. Cox analyses were conducted stepwise, initially by regions, then adjusted for demographic and clinical variables.

Results

Median OS was 10.5 months, with a 2-year OS rate of 17% and a similar 2-year RS of 0.17. Median OS improved from 9.2 months (1999–2009) to 11.2 months (2018–2023, p < 0.001), whereas 1-year RS increased from 0.38 to 0.47. Gross total resection, concomitant chemoradiotherapy and MGMT methylation were associated with significantly longer survival. Partial resection was superior to biopsy. In univariate analysis of regional differences from 2018 to 2023, the most densely populated region had a better survival than the other regions; however, after logistic regression analysis, adjusting for demographic and clinical factors, differences were statistically minor and not clinically significant.

Conclusion

In this nationwide cohort of nearly all Swedish GBM patients over 25 years, OS improved significantly over time and was associated with extent of resection, concomitant chemoradiotherapy and MGMT methylation. After adjustment for demographic and clinical factors, there were no clinically relevant regional differences.

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1999年至2023年瑞典胶质母细胞瘤生存率的提高：在分析区域差异时，全国范围内的分析强调了人口统计学和预后因素的影响——对7669名胶质母细胞瘤患者的综合分析

背景和目的胶质母细胞瘤是最常见的原发性恶性脑肿瘤，在未选择的人群中，中位生存期为9-11个月。这项瑞典全国性研究（1999-2023）评估了胶质母细胞瘤患者的生存率、地区差异及其与临床预后因素的相关性。患者/材料和方法使用瑞典原发性脑肿瘤登记处，确定了7669例胶质母细胞瘤患者。收集患者的总生存期（OS）、相对生存期（RS）、年龄、性别、术前表现状态（PPS）、肿瘤大小、手术切除分级及肿瘤治疗等数据。Cox分析首先按地区逐步进行，然后根据人口统计学和临床变量进行调整。中位OS为10.5个月，2年OS率为17%，2年RS为0.17。中位OS从9.2个月（1999-2009年）改善到11.2个月（2018-2023年，p < 0.001），而1年RS从0.38增加到0.47。大体全切除，同时进行放化疗和MGMT甲基化与更长的生存期相关。部分切除优于活检。在2018 - 2023年的区域差异单变量分析中，人口最密集的地区生存率高于其他地区；然而，经过logistic回归分析，调整人口统计学和临床因素后，差异在统计学上很小，没有临床意义。在这个涵盖了几乎所有瑞典GBM患者超过25年的全国性队列研究中，OS随着时间的推移显著改善，并且与切除程度、伴随放化疗和MGMT甲基化有关。在人口统计学和临床因素调整后，没有临床相关的区域差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.