Skip to main content
SpringerLink
Log in

Long-term survivors of glioblastoma: a closer look

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Glioblastoma has a poor prognosis with median survival of 12–14 months. Long-term survivors (LTS), alive at least 2 years from diagnosis, comprise 13% of this population. This study aims to provide a clinical profile of LTS at two institutions in Melbourne, Australia. Histological diagnosis of glioblastoma from 1st January 2006 to 31st December 2012 were identified from pathology/oncology databases. Demographic, treatment and survival characteristics were recorded (follow-up to 31st December 2015). Relevant inter-group statistics were used to identify differences between LTS and those surviving less than 2 years. Survival estimated by Kaplan–Meier. 776 patients were identified with 154 surviving > 2 years. Compared with patients surviving < 2 years, LTS were more likely to be younger (median age 56 vs. 65 years, p < .001), have ECOG 0–2 (97 vs. 65%, p < .001), gross tumour resection (91 vs. 61%, p < .001), and receive chemoradiotherapy (94 vs. 40%, p < .001). Most common presenting symptoms amongst LTS were headache (42%), seizure (28%) and speech disturbance (16%). Of LTS, 111 patients (72%) progressed at a median of 20.1 months from diagnosis, with 46% undergoing a second craniotomy. The most common non-surgical second line treatments were temozolomide (41%), followed by radiotherapy (12%). One-third of LTS received three or more lines of treatment, and 10% underwent three or more craniotomies. LTS of glioblastoma (20%) are more likely to be younger, have unilateral tumours, good performance status and undergo multimodality treatment. These data may assist in predicting LTS at diagnosis and understanding their clinical journey to facilitate planning of treatment and supportive care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352(10):987–996

    Article  CAS  PubMed  Google Scholar 

  2. Stupp R, Hegi ME, Mason WP et al (2009) Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 10(5):459–466

    Article  CAS  PubMed  Google Scholar 

  3. Ostrom QT, Gittleman H, Farah P et al (2013) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006–2010. Neuro Oncol 15(Suppl 2):ii1–ii56

    Article  PubMed  PubMed Central  Google Scholar 

  4. Meyers C, Boake C (1993) Neurobehavioral disorders experienced by brain tumor patients: rehabilitation strategies. Cancer Bull 45:362–364

    Google Scholar 

  5. Sizoo E, Dirven L, Reijneveld J et al (2014) Measuring health-related quality of life in high-grade glioma patients at the end of life using a proxy-reported retrospective questionnaire. J Neuroonc 116(2):283–290

    Article  Google Scholar 

  6. Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655

    Article  CAS  PubMed  Google Scholar 

  7. Perneger TV (1998) What’s wrong with Bonferroni adjustments. BMJ 316(7139):1236–1238

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Smoll NR, Schaller K, Gautschi OP (2013) Long-term survival of patients with glioblastoma multiforme (GBM). J Clin Neurosci 20(5):670–675

    Article  PubMed  Google Scholar 

  9. Field KM, Rosenthal MA, Yilmaz M et al (2014) Comparison between poor and long-term survivors with glioblastoma: review of an Australian dataset. Asia Pac J Clin Oncol 10(2):153–161

    Article  PubMed  Google Scholar 

  10. Scott JN, Rewcastle NB, Brasher PM et al (1999) Which glioblastoma multiforme patient will become a long-term survivor? A population-based study. Ann Neurol 46(2):183–188

    Article  CAS  PubMed  Google Scholar 

  11. Sonoda Y, Kumabe T, Watanabe M et al (2009) Long-term survivors of glioblastoma: clinical features and molecular analysis. Acta Neurochir 151(11):1349–1358

    Article  PubMed  Google Scholar 

  12. Krex D, Klink B, Hartmann C, German Glioma Network et al (2007) Long-term survival with glioblastoma multiforme. Brain 130(Pt 10):2596–2606

    Article  PubMed  Google Scholar 

  13. Hottinger AF, Yoon H, DeAngelis LM et al (2009) Neurological outcome of long-term glioblastoma survivors. J Neurooncol 95(3):301–305

    Article  PubMed  Google Scholar 

  14. Suchorska B, Weller M, Tabatabai G et al (2016) Complete resection of contrast-enhancing tumor volume is associated with improved survival in recurrent glioblastoma – results from the DIRECTOR trial. Neuro Oncol 18(4):549–556

    Article  PubMed  PubMed Central  Google Scholar 

  15. Chen MW, Morsv AA, Liang S et al (2016) Re-do craniotomy for recurrent grade IV glioblastomas: Impact and outcomes from the national neuroscience institute Singapore. World Neurosurg 87:439–445

    Article  PubMed  Google Scholar 

  16. Ening G, Huynh MT, Schmieder K et al (2015) Repeat-surgery at Glioblastoma recurrence, when and why to operate? Clin Neurol Neurosurg 136:89–94

    Article  PubMed  Google Scholar 

  17. Nava F, Tramacere I, Fittipaldo A et al (2014) Survival effect of first- and second-line treatments for patients with primary glioblastoma: a cohort study form a prospective registry, 1997–2010. Neuro Oncol 16(5):719–727

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ringel F, Pape H, Sabel M et al (2016) Clinical benefit from resection of recurrent glioblastomas: results of a multicenter study including 503 patients with recurrent glioblastomas undergoing surgical resection. Neuro Oncol 18(1):96–104

    Article  PubMed  Google Scholar 

  19. Shahar T, Nossek E, Steinberg DM et al (2012) The impact of enrolment in clinical trials on survival of patients with glioblastoma. J Clin Neurosci 19(11):1530–1534

    Article  PubMed  Google Scholar 

  20. Steinbach JP, Blaicher HP, Herrlinger U et al (2006) Surviving glioblastoma for more than 5 years: the patient’s perspective. Neurology 66:239–242

    Article  CAS  PubMed  Google Scholar 

  21. Flechl B, Ackerl M, Sax C et al (2012) Neurocognitive and sociodemographic functioning of glioblastoma long-term survivors. J Neurooncol 109:331–339

    Article  PubMed  Google Scholar 

Download references

Funding

This study was funded by St Vincent’s Research Endowment Fund Grant (81,779).

Author information

Authors and Affiliations

  1. St Vincent’s Hospital, Melbourne, VIC, Australia

    Lucy Gately, Sue-Anne McLachlan & Anthony Dowling

  2. Centre for Palliative Care, Melbourne, VIC, Australia

    Jennifer Philip

  3. Alfred Hospital and Monash University, Melbourne, VIC, Australia

    Jeremy Ruben

Authors
  1. Lucy Gately
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sue-Anne McLachlan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jennifer Philip
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jeremy Ruben
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anthony Dowling
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lucy Gately.

Ethics declarations

Conflict of interest

All authors declare that there is no conflict of interest.

Ethical approval

This study did not require participation from human patients. The study was approved by the Institutional Human Ethics Committee at St Vincent’s Hospital, Melbourne, and The Alfred Hospital, Melbourne.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gately, L., McLachlan, SA., Philip, J. et al. Long-term survivors of glioblastoma: a closer look. J Neurooncol 136, 155–162 (2018). https://doi.org/10.1007/s11060-017-2635-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-017-2635-1

Keywords

Search

Navigation