Comparison between poor and long-term survivors with glioblastoma: Review of an Australian dataset

Aims: Despite the largely poor prognosis for patients with glioblastoma, 5-year survival approaches 10%. In many circumstances the reasons for discrepant outcomes remain unknown. This retrospective cohort study compared clinical and socio-demographic variables between long-term and poor survivors with glioblastoma. Methods: Data from patients with glioblastoma diagnosed from 1998-2010 were accessed from two institutions. The cohort was divided into poor (<6 months), average (6-24 months) and long-term (>24 months) survivors. Clinical and socio-demographic variables were compared. Results: In total 529 patients were included; 221 (42%) were poor, 260 (49%) average and 48 (9%) long-term survivors. Those surviving >24 months were younger and significantly more likely to be in a higher socioeconomic status group; be of a better performance status; have a frontal lobe tumor; have a craniotomy (rather than a biopsy); have a macroscopic resection; have two or more operations; and participate in a clinical trial. Country of birth, regional versus city residence and public versus private hospital treatment were not associated with differential survival outcomes. An ordered logistic regression analysis showed that age, performance status, extent of resection and clinical trial participation were independently associated with survival. Conclusion: Reassuringly, no statistically significant socio-demographic differences exist when comparing long-term and poor survivors with glioblastoma. Patients surviving more than 2 years were significantly more likely to have participated in a clinical trial. This research could contribute towards informing further research on prognostic variables for patients with glioblastoma.