1
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Edström S, Hellquist BN, Sandström M, Sadanandan SA, Björkblom B, Melin B, Sjöberg RL. Antidepressants and survival in glioma-A registry-based retrospective cohort study. Neurooncol Pract 2024; 11:125-131. [PMID: 38496917 PMCID: PMC10940821 DOI: 10.1093/nop/npad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Background Depression and treatment with antidepressant medication is common in patients with malignant glioma. However, the extent to which antidepressants may affect the disease is not fully understood. Therefore, the purpose of the present study was to investigate possible associations between treatment with antidepressant medication and survival in glioma patients. Methods We performed a registry-based cohort study including 1231 patients with malignant glioma (WHO grades 2, 3, and 4) having undergone surgery, and 6400 matched controls without glioma. All data were extracted from the RISK North database, which contains information from multiple national population-based registries in Sweden. Results Treatment with antidepressants is more common in patients with malignant glioma (27%), compared to controls (16%), P < .001. Treatment with antidepressants after surgery for glioma was significantly associated with poorer survival. These effects were observed both for selective serotonin reuptake inhibitors (SSRIs) and non-SSRIs. In grade 4 glioma, SSRI treatment was associated with a hazard ratio (HR) of 3.32 (95% CI 2.69-4.10, P < .001), and non-SSRI treatment a HR of 3.54 (95% CI 2.52-4.99, P < .001), compared to glioma patients without antidepressants. In grade 2-3 glioma, the HR for SSRI treatment was 3.26 (95% CI 2.19-4.85, P < .001), and for non-SSRI treatment was 7.71 (95% CI 4.22-14.12, P < .001). Conclusions Our results demonstrate a negative association between antidepressant medication and survival in glioma. Further research will be needed to clarify causation.
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Affiliation(s)
- Sonja Edström
- Department of Clinical Sciences, Neurosciences, Umeå University, Umeå, Sweden
| | | | - Maria Sandström
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | | | | | - Beatrice Melin
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Rickard L Sjöberg
- Department of Clinical Sciences, Neurosciences, Umeå University, Umeå, Sweden
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2
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Löfgren D, Valachis A, Olivecrona M. Risk for morbidity and mortality after neurosurgery in older patients with high grade gliomas - a retrospective population based study. BMC Geriatr 2022; 22:805. [PMID: 36253725 PMCID: PMC9575213 DOI: 10.1186/s12877-022-03478-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 09/23/2022] [Indexed: 12/04/2022] Open
Abstract
Background Although high grade gliomas largely affect older patients, current evidence on neurosurgical complications is mostly based on studies including younger study populations. We aimed to investigate the risk for postoperative complications after neurosurgery in a population-based cohort of older patients with high grade gliomas, and explore changes over time. Methods In this retrospective study we have used data from the Swedish Brain Tumour Registry and included patients in Sweden age 65 years or older, with surgery 1999–2017 for high grade gliomas. We analysed number of surgical procedures per year and which factors contribute to postoperative morbidity and mortality. Results The study included 1998 surgical interventions from an area representing 60% of the Swedish population. Over time, there was an increase in surgical interventions in relation to the age specific population (p < 0.001). Postoperative morbidity for 2006–2017 was 24%. Resection and not having a multifocal tumour were associated with higher risk for postoperative morbidity. Postoperative mortality for the same period was 5%. Increased age, biopsy, and poor performance status was associated with higher risk for postoperative mortality. Conclusions This study shows an increase in surgical interventions over time, probably representing a more active treatment approach. The relatively low postoperative morbidity- and mortality-rates suggests that surgery in older patients with suspected high grade gliomas can be a feasible option. However, caution is advised in patients with poor performance status where the possible surgical intervention would be a biopsy only. Further, this study underlines the need for more standardised methods of reporting neurosurgical complications. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03478-6.
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Affiliation(s)
- David Löfgren
- Department of Oncology, Faculty of Medicine & Health, Örebro University, SE 70182, Örebro, Sweden.
| | - Antonios Valachis
- Department of Oncology, Faculty of Medicine & Health, Örebro University, SE 70182, Örebro, Sweden
| | - Magnus Olivecrona
- Department of Neurosurgery, Faculty of Medicine & Health, Örebro University, SE 70182, Örebro, Sweden
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3
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Wettergren L, Eriksson LE, Bergström C, Hedman C, Ahlgren J, Smedby KE, Hellman K, Henriksson R, Lampic C. Prevalence and risk factors for sexual dysfunction in young women following a cancer diagnosis - a population-based study. Acta Oncol 2022; 61:1165-1172. [PMID: 36176069 DOI: 10.1080/0284186x.2022.2112283] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Self-reported sex problems among women diagnosed with reproductive and nonreproductive cancers before the age of 40 are not fully understood. This study aimed to determine sexual dysfunction in young women following a cancer diagnosis in relation to women of the general population. Furthermore, to identify factors associated with sexual dysfunction in women diagnosed with cancer. MATERIALS AND METHODS A population-based cross-sectional study with 694 young women was conducted 1.5 years after being diagnosed with cancer (response rate 72%). Potential participants were identified in national quality registries covering breast and gynecological cancer, lymphoma and brain tumors. The women with cancer were compared to a group of women drawn from the general population (N = 493). Sexual activity and function were assessed with the PROMIS® SexFS. Logistic regression was used to assess differences between women with cancer and the comparison group, and to identify factors associated with sexual dysfunction. RESULTS The majority of the women with cancer (83%) as well as the women from the comparison group (87%) reported having had sex the last month (partner sex and/or masturbation). More than 60% of the women with cancer (all diagnoses) reported sexual dysfunction in at least one of the measured domains. The women with cancer reported statistically significantly more problems than women of the comparison group across domains such as decreased interest in having sex, and vaginal and vulvar discomfort. Women with gynecological or breast cancer and those receiving more intense treatment were at particular high risk of sexual dysfunction (≥2 domains). Concurrent emotional distress and body image disturbance were associated with more dysfunction. CONCLUSION The results underscore the need to routinely assess sexual health in clinical care and follow-up. Based on the results, development of interventions to support women to cope with cancer-related sexual dysfunction is recommended.
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Affiliation(s)
- Lena Wettergren
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Lars E Eriksson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,School of Health and Psychological Sciences, City, University of London, London, United Kingdom.,Medical Unit Infectious Diseases, Karolinska University Hospital, Huddinge, Sweden
| | - Charlotta Bergström
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery and Urology, Danderyd University Hospital, Sweden
| | - Christel Hedman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,R & D department, Stockholms Sjukhem Foundation, Stockholm, Sweden.,Division of Palliative Care, Department of Clinical Sciences Lund, Lund University, Sweden
| | - Johan Ahlgren
- Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Regional cancer centre, Mid-Sweden, Uppsala, Sweden
| | - Karin E Smedby
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.,Center for Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Hellman
- Department of Gynecologic Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Roger Henriksson
- Department of Radiation Science and Oncology, University Hospital, Umeå, Sweden
| | - Claudia Lampic
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Umeå University, Umeå, Sweden
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4
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Hedman C, Ahlgren J, Smedby KE, Hellman K, Henriksson R, Ståhl O, Wettergren L, Lampic C. Cancer in young adulthood - classifying the intensity of treatment. Acta Oncol 2022; 61:809-813. [PMID: 35575147 DOI: 10.1080/0284186x.2022.2071110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- C. Hedman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- R & D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden
- Division of Palliative Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - J. Ahlgren
- Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Regional Cancer Centre, Uppsala‐Örebro, Uppsala, Sweden
| | - K. E. Smedby
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - K. Hellman
- Department of Gynecologic Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - R. Henriksson
- Department of Radiation Science and Oncology, University Hospital, Umeå, Sweden
| | - O. Ståhl
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - L. Wettergren
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - C. Lampic
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Umeå University, Umeå, Sweden
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5
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Sex Differences in Glioblastoma—Findings from the Swedish National Quality Registry for Primary Brain Tumors between 1999–2018. J Clin Med 2022; 11:jcm11030486. [PMID: 35159938 PMCID: PMC8837060 DOI: 10.3390/jcm11030486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/05/2022] [Accepted: 01/14/2022] [Indexed: 02/01/2023] Open
Abstract
Sex disparities in glioblastoma (GBM) have received increasing attention. Sex-related differences for several molecular markers have been reported, which could impact on clinical factors and outcomes. We therefore analyzed data on all patients with GBM reported to the Swedish National Quality Registry for Primary Brain Tumors, according to sex, with a focus on prognostic factors and survival. All glioma patients registered during 20 years, from 1 January 1999 until 31 December 2018, with SNOMED codes 94403, 94413, and 94423, were analyzed. Chi2-test, log-rank test, and Kaplan–Meier analyses were performed. We identified 5243 patients, of which 2083 were females and 3160 males, resulting in a ratio of 1:1.5. We found sex related differences, with women having diagnostic surgery at a significantly higher age (p = 0.001). Women were also reported to have a worse preoperative performance status (PPS) (<0.001). There was no gender difference for the type of surgery performed. For women with radical surgery, overall survival was slightly better than for men (p = 0.045). The time period did not influence survival, neither for 1999–2005 nor 2006–2018, after temozolomide treatment was introduced (p = 0.35 and 0.10, respectively). In the multivariate analysis including sex, age, surgery, and PPS, a survival advantage was noted for women, but this was not clinically relevant (HR = 0.92, p = 0.006). For patients with GBM; sex-related differences in clinical factors could be identified in a population-based cohort. In this dataset, for survival, the only advantage noted was for women who had undergone radical surgery, although this was clinically almost negligible.
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6
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Löfgren D, Valachis A, Olivecrona M. Older meningioma patients: a retrospective population-based study of risk factors for morbidity and mortality after neurosurgery. Acta Neurochir (Wien) 2022; 164:2987-2997. [PMID: 35978200 PMCID: PMC9613739 DOI: 10.1007/s00701-022-05336-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Meningioma is the most common primary CNS tumour. Most meningiomas are benign, and most patients are 65 years or older. Surgery is usually the primary treatment option. Most prior studies on early surgical outcomes in older patients with meningioma are small, and there is a lack of larger population-based studies to guide clinical decision-making. We aimed to explore the risks for perioperative mortality and morbidity in older patients with meningioma and to investigate changes in surgical incidence over time. METHODS In this retrospective population-based study on patients in Sweden, 65 years or older with surgery 1999-2017 for meningioma, we used data from the Swedish Brain Tumour Registry. We analysed factors contributing to perioperative mortality and morbidity and used official demographic data to calculate yearly incidence of surgical procedures for meningioma. RESULTS The final study cohort included 1676 patients with a 3.1% perioperative mortality and a 37.6% perioperative morbidity. In multivariate analysis, higher age showed a statistically significant association with higher perioperative mortality, whereas larger tumour size and having preoperative symptoms were associated with higher perioperative morbidity. A numerical increased rate of surgical interventions after 2012 was observed, without evidence of worsening short-term surgical outcomes. CONCLUSIONS Higher mortality with increased age and higher morbidity risk in larger and/or symptomatic tumours imply a possible benefit from considering surgery in selected older patients with a growing meningioma before the development of tumour-related symptoms. This study further underlines the need for a standardized method of reporting and classifying complications from neurosurgery.
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Affiliation(s)
- David Löfgren
- Department of Oncology, Faculty of Medicine & Health, Örebro University, 70182 Örebro, SE Sweden
| | - Antonios Valachis
- Department of Oncology, Faculty of Medicine & Health, Örebro University, 70182 Örebro, SE Sweden
| | - Magnus Olivecrona
- Department of Neurosurgery, Faculty of Medicine & Health, Örebro University, 70182 Örebro, SE Sweden
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7
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Ostrom QT, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2014-2018. Neuro Oncol 2021; 23:iii1-iii105. [PMID: 34608945 PMCID: PMC8491279 DOI: 10.1093/neuonc/noab200] [Citation(s) in RCA: 775] [Impact Index Per Article: 258.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the CDC and NCI, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy and is the first CBTRUS Report to provide the distribution of molecular markers for selected brain and CNS tumor histologies. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 24.25 (Malignant AAAIR=7.06, Non-malignant AAAIR=17.18). This overall rate was higher in females compared to males (26.95 versus 21.35) and non-Hispanics compared to Hispanics (24.68 versus 22.12). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.3% of all tumors and 49.1% of malignant tumors), and the most common non-malignant tumor was meningioma (39% of all tumors and 54.5% of non-malignant tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.21. An estimated 88,190 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US population in 2021 (25,690 malignant and 62,500 non-malignant). There were 83,029 deaths attributed to malignant brain and other CNS tumors between 2014 and 2018. This represents an average annual mortality rate of 4.43 per 100,000 and an average of 16,606 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 66.9%, for a non-malignant brain and other CNS tumors the five-year relative survival rate was 92.1%.
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Affiliation(s)
- Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Gino Cioffi
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Trans Divisional Research Program (TDRP), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Bethesda, MD, USA
| | - Kristin Waite
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Trans Divisional Research Program (TDRP), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Bethesda, MD, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Jill S Barnholtz-Sloan
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Trans Divisional Research Program (TDRP), Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Bethesda, MD, USA
- Center for Biomedical Informatics & Information Technology (CBIIT), National Cancer Institute, Bethesda, MD, USA
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8
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Müller DMJ, Robe PA, Ardon H, Barkhof F, Bello L, Berger MS, Bouwknegt W, Van den Brink WA, Conti Nibali M, Eijgelaar RS, Furtner J, Han SJ, Hervey-Jumper SL, Idema AJS, Kiesel B, Kloet A, Mandonnet E, De Munck JC, Rossi M, Sciortino T, Vandertop WP, Visser M, Wagemakers M, Widhalm G, Witte MG, Zwinderman AH, De Witt Hamer PC. On the cutting edge of glioblastoma surgery: where neurosurgeons agree and disagree on surgical decisions. J Neurosurg 2021; 136:45-55. [PMID: 34243150 DOI: 10.3171/2020.11.jns202897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/30/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of glioblastoma surgery is to maximize the extent of resection while preserving functional integrity. Standards are lacking for surgical decision-making, and previous studies indicate treatment variations. These shortcomings reflect the need to evaluate larger populations from different care teams. In this study, the authors used probability maps to quantify and compare surgical decision-making throughout the brain by 12 neurosurgical teams for patients with glioblastoma. METHODS The study included all adult patients who underwent first-time glioblastoma surgery in 2012-2013 and were treated by 1 of the 12 participating neurosurgical teams. Voxel-wise probability maps of tumor location, biopsy, and resection were constructed for each team to identify and compare patient treatment variations. Brain regions with different biopsy and resection results between teams were identified and analyzed for patient functional outcome and survival. RESULTS The study cohort consisted of 1087 patients, of whom 363 underwent a biopsy and 724 a resection. Biopsy and resection decisions were generally comparable between teams, providing benchmarks for probability maps of resections and biopsies for glioblastoma. Differences in biopsy rates were identified for the right superior frontal gyrus and indicated variation in biopsy decisions. Differences in resection rates were identified for the left superior parietal lobule, indicating variations in resection decisions. CONCLUSIONS Probability maps of glioblastoma surgery enabled capture of clinical practice decisions and indicated that teams generally agreed on which region to biopsy or to resect. However, treatment variations reflecting clinical dilemmas were observed and pinpointed by using the probability maps, which could therefore be useful for quality-of-care discussions between surgical teams for patients with glioblastoma.
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Affiliation(s)
- Domenique M J Müller
- 1Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit, Cancer Center Amsterdam
| | - Pierre A Robe
- 2Department of Neurology and Neurosurgery, University Medical Center Utrecht
| | - Hilko Ardon
- 3Department of Neurosurgery, St. Elisabeth Hospital, Tilburg
| | - Frederik Barkhof
- 4Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,5Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom
| | - Lorenzo Bello
- 6Neurosurgical Oncology Unit, Department of Oncology and Remato-Oncology, Università degli Studi di Milano, Humanitas Research Hospital, IRCCS, Milan, Italy
| | - Mitchel S Berger
- 7Department of Neurological Surgery, University of California, San Francisco, California
| | - Wim Bouwknegt
- 8Department of Neurosurgery, Medical Center Slotervaart, Amsterdam
| | | | - Marco Conti Nibali
- 6Neurosurgical Oncology Unit, Department of Oncology and Remato-Oncology, Università degli Studi di Milano, Humanitas Research Hospital, IRCCS, Milan, Italy
| | - Roelant S Eijgelaar
- 10Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Julia Furtner
- 11Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Austria
| | - Seunggu J Han
- 12Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon
| | - Shawn L Hervey-Jumper
- 7Department of Neurological Surgery, University of California, San Francisco, California
| | - Albert J S Idema
- 13Department of Neurosurgery, Northwest Clinics, Alkmaar, The Netherlands
| | - Barbara Kiesel
- 14Department of Neurological Surgery, Medical University Vienna, Austria
| | - Alfred Kloet
- 15Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands
| | - Emmanuel Mandonnet
- 16Department of Neurological Surgery, Hôpital Lariboisière, Paris, France
| | - Jan C De Munck
- 4Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marco Rossi
- 6Neurosurgical Oncology Unit, Department of Oncology and Remato-Oncology, Università degli Studi di Milano, Humanitas Research Hospital, IRCCS, Milan, Italy
| | - Tommaso Sciortino
- 6Neurosurgical Oncology Unit, Department of Oncology and Remato-Oncology, Università degli Studi di Milano, Humanitas Research Hospital, IRCCS, Milan, Italy
| | - W Peter Vandertop
- 1Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit, Cancer Center Amsterdam
| | - Martin Visser
- 4Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Michiel Wagemakers
- 17Department of Neurosurgery, University of Groningen, University Medical Center Groningen; and
| | - Georg Widhalm
- 14Department of Neurological Surgery, Medical University Vienna, Austria
| | - Marnix G Witte
- 10Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Aeilko H Zwinderman
- 18Department of Clinical Epidemiology and Biostatistics, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
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Ostrom QT, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2013-2017. Neuro Oncol 2021; 22:iv1-iv96. [PMID: 33123732 DOI: 10.1093/neuonc/noaa200] [Citation(s) in RCA: 1087] [Impact Index Per Article: 362.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control (CDC) and National Cancer Institute (NCI), is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors (malignant and non-malignant) and supersedes all previous CBTRUS reports in terms of completeness and accuracy. All rates (incidence and mortality) are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 23.79 (Malignant AAAIR=7.08, non-Malignant AAAIR=16.71). This rate was higher in females compared to males (26.31 versus 21.09), Blacks compared to Whites (23.88 versus 23.83), and non-Hispanics compared to Hispanics (24.23 versus 21.48). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.5% of all tumors), and the most common non-malignant tumor was meningioma (38.3% of all tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.14. An estimated 83,830 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US in 2020 (24,970 malignant and 58,860 non-malignant). There were 81,246 deaths attributed to malignant brain and other CNS tumors between 2013 and 2017. This represents an average annual mortality rate of 4.42. The 5-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 23.5% and for a non-malignant brain and other CNS tumor was 82.4%.
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Affiliation(s)
- Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Nirav Patil
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Cleveland Center for Health Outcomes Research, Cleveland, Ohio, USA.,University Hospitals Health System, Research and Education Institute
| | - Gino Cioffi
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Cleveland Center for Health Outcomes Research, Cleveland, Ohio, USA
| | - Kristin Waite
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Cleveland Center for Health Outcomes Research, Cleveland, Ohio, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Jill S Barnholtz-Sloan
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Cleveland Center for Health Outcomes Research, Cleveland, Ohio, USA.,University Hospitals Health System, Research and Education Institute
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10
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Rydén I, Thurin E, Carstam L, Smits A, Gulati S, Henriksson R, Salvesen Ø, Store Jakola A. Psychotropic and anti-epileptic drug use, before and after surgery, among patients with low-grade glioma: a nationwide matched cohort study. BMC Cancer 2021; 21:248. [PMID: 33685410 PMCID: PMC7938599 DOI: 10.1186/s12885-021-07939-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/19/2021] [Indexed: 01/10/2023] Open
Abstract
Background Low-grade glioma (LGG) is a relatively rare type of brain tumour. The use of antidepressant, sedative and anti-epileptic drugs can reflect the burden of the disease. While epilepsy is well-described in patients with LGG, less is known about depression and anxiety. Methods We used nationwide registers to study the use (dispense) of antidepressants, sedatives, and anti-epileptic drugs (AEDs) before and after histopathological LGG diagnosis (WHO grade II). A total of 485 adult patients with a first-time diagnosis and a matched control cohort (n = 2412) were included. Patterns of use were analysed from one year prior to until one year following index date (date of surgery). Logistic regression analysis identified predictors for postoperative use. Results At one year before index date, patients were dispensed AEDs 4 times more than controls, while antidepressants and sedatives were similar. Sedatives and AED peaked shortly after index date at 25 and 69%, respectively. AEDs then stabilized while sedatives decreased rapidly. For antidepressants, a delayed increase was seen after index date, stabilizing at 12%. At one year after index date, the use of antidepressants, sedatives, and AEDs among patients was 2, 3, and 26 times higher, respectively, compared to controls. Predictor for use of AEDs and sedatives at one year following index was previous use and/or a related diagnosis. Female sex and later index year were additional predictors for antidepressants. Conclusions Use of antidepressants, sedatives and AEDs is elevated following diagnosis of LGG. Antidepressants were more commonly dispensed to female patients and in recent years. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-07939-w.
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Affiliation(s)
- Isabelle Rydén
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Blå stråket 7, 3 tr, 413 45, Gothenburg, Sweden.
| | - Erik Thurin
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Blå stråket 7, 3 tr, 413 45, Gothenburg, Sweden
| | - Louise Carstam
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Blå stråket 7, 3 tr, 413 45, Gothenburg, Sweden.,Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anja Smits
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Blå stråket 7, 3 tr, 413 45, Gothenburg, Sweden
| | - Sasha Gulati
- Department of Neurosurgery, St.Olavs University Hospital HF, Trondheim, Norway
| | - Roger Henriksson
- Department of Radiation Sciences and Oncology, University of Umea, Umeå, Sweden
| | - Øyvind Salvesen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asgeir Store Jakola
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Blå stråket 7, 3 tr, 413 45, Gothenburg, Sweden.,Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Neurosurgery, St.Olavs University Hospital HF, Trondheim, Norway
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11
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Abstract
Glioblastoma remains incurable despite advances in surgery, radiation, and chemotherapy, underscoring the need for new therapies. The genetic heterogenicity, presence of redundant molecular pathways, and the blood-brain barrier have limited the applicability of molecularly targeted agents. The therapeutic benefit seen with a small subset of patients suggests, however, that patient selection is critical. Recent investigations show that molecularly targeted synthetic lethality is a promising complementary approach. The article provides an overview of the challenges of molecularly targeted therapy in adults with glioblastoma, including current trials and future therapeutic directions.
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Affiliation(s)
- Matthew A Smith-Cohn
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, 37 Convent Drive, Building 37, Room 1016, Bethesda, MD 20892, USA; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Orieta Celiku
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, 37 Convent Drive, Building 37, Room 1142, Bethesda, MD 20892, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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12
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Ostrom QT, Cioffi G, Gittleman H, Patil N, Waite K, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012-2016. Neuro Oncol 2020; 21:v1-v100. [PMID: 31675094 DOI: 10.1093/neuonc/noz150] [Citation(s) in RCA: 1549] [Impact Index Per Article: 387.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention and National Cancer Institute, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 23.41 (Malignant AAAIR = 7.08, non-Malignant AAAIR = 16.33). This rate was higher in females compared to males (25.84 versus 20.82), Whites compared to Blacks (23.50 versus 23.34), and non-Hispanics compared to Hispanics (23.84 versus 21.28). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.6% of all tumors), and the most common non-malignant tumor was meningioma (37.6% of all tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.06. An estimated 86,010 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US in 2019 (25,510 malignant and 60,490 non-malignant). There were 79,718 deaths attributed to malignant brain and other CNS tumors between 2012 and 2016. This represents an average annual mortality rate of 4.42. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 35.8%, and the five-year relative survival rate following diagnosis of a non-malignant brain and other CNS tumors was 91.5%.
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Affiliation(s)
- Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Gino Cioffi
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Cleveland Center for Health Outcomes Research, Cleveland, Ohio, USA
| | - Haley Gittleman
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Nirav Patil
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Kristin Waite
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Cleveland Center for Health Outcomes Research, Cleveland, Ohio, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Jill S Barnholtz-Sloan
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Cleveland Center for Health Outcomes Research, Cleveland, Ohio, USA
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13
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Rydén I, Carstam L, Gulati S, Smits A, Sunnerhagen KS, Hellström P, Henriksson R, Bartek J, Salvesen Ø, Jakola AS. Return to work following diagnosis of low-grade glioma: A nationwide matched cohort study. Neurology 2020; 95:e856-e866. [PMID: 32540938 PMCID: PMC7605502 DOI: 10.1212/wnl.0000000000009982] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/27/2020] [Indexed: 01/11/2023] Open
Abstract
Objective Return-to-work (RTW) following diagnosis of infiltrative low-grade gliomas is unknown. Methods Swedish patients with histopathologic verified WHO grade II diffuse glioma diagnosed between 2005 and 2015 were included. Data were acquired from several Swedish registries. A total of 381 patients aged 18–60 were eligible. A matched control population (n = 1,900) was acquired. Individual data on sick leave, compensations, comorbidity, and treatments assigned were assessed. Predictors were explored using multivariable logistic regression. Results One year before surgery/index date, 88% of cases were working, compared to 91% of controls. The proportion of controls working remained constant, while patients had a rapid increase in sick leave approximately 6 months prior to surgery. After 1 and 2 years, respectively, 52% and 63% of the patients were working. Predictors for no RTW after 1 year were previous sick leave (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.88–0.96, p < 0.001), older age (OR 0.96, 95% CI 0.94–0.99, p = 0.005), and lower functional level (OR 0.64 95% CI, 0.45–0.91 p = 0.01). Patients receiving adjuvant treatment were less likely to RTW within the first year. At 2 years, biopsy (as opposed to resection), female sex, and comorbidity were also unfavorable, while age and adjuvant treatment were no longer significant. Conclusions Approximately half of patients RTW within the first year. Lower functional status, previous sick leave, older age, and adjuvant treatment were risk factors for no RTW at 1 year after surgery. Female sex, comorbidity, and biopsy only were also unfavorable for RTW at 2 years.
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Affiliation(s)
- Isabelle Rydén
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Louise Carstam
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Sasha Gulati
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Anja Smits
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Katharina S Sunnerhagen
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Per Hellström
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Roger Henriksson
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Jiri Bartek
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Øyvind Salvesen
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Asgeir Store Jakola
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark.
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14
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Bartek J, Dhawan S, Thurin E, Alattar A, Gulati S, Rydenhag B, Henriksson R, Chen CC, Jakola AS. Short-term outcome following surgery for rare brain tumor entities in adults: a Swedish nation-wide registry-based study and comparison with SEER database. J Neurooncol 2020; 148:281-290. [PMID: 32424575 PMCID: PMC7316679 DOI: 10.1007/s11060-020-03490-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 04/08/2020] [Indexed: 01/03/2023]
Abstract
Objective To investigate outcomes after surgery for rare brain tumors using the Swedish Brain Tumor Registry (SBTR). Methods This is a nationwide study of patient in the SBTR, validated in the Surveillance, Epidemiology, and End Results (SEER) registries. We included all adults diagnosed 2009–2015 with a rare brain tumor entity (n = 216), defined as ependymoma (EP, n = 64), subependymoma (SUBEP, n = 21), ganglioglioma (GGL, n = 54), pilocytic astrocytoma (PA, n = 56) and primitive neuroectodermal tumor (PNET, n = 21). We analyzed symptomatology, tumor characteristics and outcomes. Results Mean age was 38.3 ± 17.2 years in GGL, 36.2 ± 16.9 in PA, 37.0 ± 19.1 in PNET, 51.7 ± 16.3 in EP and 49.8 ± 14.3 in SUBEP. The most common symptom was focal deficit (39.6–71.4%), and this symptom was most common in GGL patients with 64.2% of GGL presenting with seizures. Most patients had no or little restriction in activity before surgery (Performance Status 0–1), although up to 15.0% of PNET patients had a performance status of 4. Gross total resection was achieved in most (> 50%) tumor categories. Incidence of new deficits was 11.1–34.4%. In terms of postoperative complications, 0–4.8% had a hematoma of any kind, 1.9–15.6% an infection, 0–7.8% a venous thromboembolism and 3.7–10.9% experienced a complication requiring reoperation. There were 3 deaths within 30-days of surgery, and a 1-year mortality of 0–14.3%. Conclusion We have provided benchmarks for the current symptomatology, tumor characteristics and outcomes after surgery for rare brain tumors as collected by the SBTR and validated our results in an independent registry. These results may aid in clinical decision making and advising patients.
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Affiliation(s)
- Jiri Bartek
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
- Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
- Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Sanjay Dhawan
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA
| | - Erik Thurin
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Ali Alattar
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sasha Gulati
- Department of Neurosurgery, St. Olav University Hospital, Trondheim, Norway
| | - Bertil Rydenhag
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Roger Henriksson
- Department of Radiation Sciences, University of Umeå, S-901 85, Umeå, Sweden
| | - Clark C Chen
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA
| | - Asgeir Store Jakola
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Neurosurgery, St. Olav University Hospital, Trondheim, Norway
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
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15
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Lyakhova I, Piatkova M, Gulaia V, Romanishin A, Shmelev M, Bryukhovetskiy A, Sharma A, Sharma HS, Khotimchenko R, Bryukhovetskiy I. Alkaloids of fascaplysin are promising chemotherapeutic agents for the treatment of glioblastoma: Review. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 151:299-324. [PMID: 32448613 DOI: 10.1016/bs.irn.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Glioblastoma is one of the most aggressive human brain tumors. Even following all the modern protocols of complex treatment, the median patient survival typically does not exceed 15 months. This review analyzes the main reasons for glioblastoma resistance to therapy, as well as attempts at categorizing the main approaches to increasing chemotherapy efficiency. Special emphasis is placed on the specific group of compounds, known as marine alkaloids and their synthetic derivatives exerting a general antitumor effect on glioblastoma cells. The unique mechanisms of marine alkaloid influence on the tumor cells prompt considering them as a promising basis for creating new chemotherapeutic agents for glioblastoma treatment.
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Affiliation(s)
- Irina Lyakhova
- Department of Fundamental Medicine, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia
| | - Mariia Piatkova
- Department of Fundamental Medicine, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia
| | - Valeriia Gulaia
- Laboratory of Biomedical Cell Technologies, Department of Medical Biology and Biotechnology, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia
| | - Aleksandr Romanishin
- Laboratory of Biomedical Cell Technologies, Department of Medical Biology and Biotechnology, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia
| | - Mikhail Shmelev
- Laboratory of Biomedical Cell Technologies, Department of Medical Biology and Biotechnology, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia
| | - Andrey Bryukhovetskiy
- NeuroVita Clinic of Interventional and Restorative Neurology and Therapy, Moscow, Russia
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, University Hospital, Uppsala University, S-75185 Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, University Hospital, Uppsala University, S-75185 Uppsala, Sweden
| | - Rodion Khotimchenko
- Department of Fundamental Medicine, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia; Laboratory of Pharmacology, National Scientific Center of Marine Biology, Far East Branch of the Russian Academy of Sciences, Vladivostok, Russia
| | - Igor Bryukhovetskiy
- Department of Fundamental Medicine, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia; Laboratory of Pharmacology, National Scientific Center of Marine Biology, Far East Branch of the Russian Academy of Sciences, Vladivostok, Russia.
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16
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Werlenius K, Fekete B, Blomstrand M, Carén H, Jakola AS, Rydenhag B, Smits A. Patterns of care and clinical outcome in assumed glioblastoma without tissue diagnosis: A population-based study of 131 consecutive patients. PLoS One 2020; 15:e0228480. [PMID: 32053655 PMCID: PMC7017992 DOI: 10.1371/journal.pone.0228480] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/15/2020] [Indexed: 11/19/2022] Open
Abstract
Background Elderly patients with glioblastoma and an accumulation of negative prognostic factors have an extremely short survival. There is no consensus on the clinical management of these patients and many may escape histologically verified diagnosis. The primary aim of this study was to characterize this particular subgroup of patients with radiological glioblastoma diagnosis without histological verification. The secondary aim was to evaluate if oncological therapy was of benefit. Methods Between November 2012 and June 2016, all consecutive patients presenting with a suspected glioblastoma in the western region of Sweden were registered in a population-based study. Of the 378 patients, 131 (35%) met the inclusion criteria of the present study by typical radiological features of glioblastoma without histological verification. Results The clinical characteristics of the 131 patients (72 men, 59 women) were: age ≥ 75 (n = 99, 76%), performance status according to Eastern Cooperative Oncology Group ≥ 2 (n = 93, 71%), significant comorbidity (n = 65, 50%) and multilobular tumors (n = 90, 69%). The overall median survival rate was 3.6 months. A subgroup of 44 patients (34%) received upfront treatment with temozolomide, with an overall radiological response rate of 34% and a median survival of 6.8 months, compared to 2.7 months for those receiving best supportive care only. Good performance status and temozolomide treatment were statistically significant favorable prognostic factors, while younger age was not. Conclusion Thirty-five percent of patients with a radiological diagnosis of glioblastoma in our region lacked histological diagnosis. Apart from high age and poor performance status, they had more severe comorbidities and extensive tumor spread. Even for this poor prognostic group upfront treatment with temozolomide was shown of benefit in a subgroup of patients. Our data illustrate the need of non-invasive diagnostic methods to guide optimal individualized therapy for patients considered too fragile for neurosurgical biopsy.
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Affiliation(s)
- Katja Werlenius
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- * E-mail:
| | - Boglarka Fekete
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
| | - Malin Blomstrand
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helena Carén
- Sahlgrenska Cancer Center, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Asgeir S. Jakola
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bertil Rydenhag
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anja Smits
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Neuroscience, Neurology, Uppsala University, Gothenburg, Sweden
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17
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Socioeconomic factors affect treatment delivery for patients with low grade glioma: a Swedish population-based study. J Neurooncol 2019; 146:329-337. [PMID: 31883050 PMCID: PMC6971149 DOI: 10.1007/s11060-019-03378-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 12/20/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Despite aspirations to achieve equality in healthcare we know that socioeconomic differences exist and may affect treatment and patient outcome, also in serious diseases such as cancer. We investigated disparities in neurosurgical care and outcome for patients with low-grade glioma (LGG). METHODS In this nationwide registry-based study, patients who had undergone surgery for LGG during 2005-2015 were identified (n = 547) through the Swedish Brain Tumor Registry. We linked data to multiple national registries with individual level data on income, education and comorbidity and analyzed the association of disease characteristics, surgical management and outcome, with levels of income, education and sex. RESULTS Patients with either low income, low education or female gender showed worse pre-operative performance status. Patients with low income or education also had more comorbidities and those with low education endured longer waiting times for surgery. Median time from radiological imaging to surgery was 51 days (Q1-3 27-191) for patients with low education, compared to 32 days (Q1-3 20-80) for patients with high education (p = 0.006). Differences in waiting time over educational levels remained significant after stratification for age, comorbidity, preoperative performance status, and tumor size. Overall survival was better for patients with high income or high education, but income- and education-related survival differences were not significant after adjustment for age and comorbidity. The type of surgical procedure or complications did not differ over socioeconomic groups or sex. CONCLUSION The neurosurgical care for LGG in Sweden, a society with universal healthcare, displays differences that can be related to socioeconomic factors.
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Thurin E, Corell A, Gulati S, Smits A, Henriksson R, Bartek J, Salvesen Ø, Jakola AS. Return to work following meningioma surgery: a Swedish nationwide registry-based matched cohort study. Neurooncol Pract 2019; 7:320-328. [PMID: 32528713 PMCID: PMC7274187 DOI: 10.1093/nop/npz066] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Meningioma is the most common primary intracranial tumor. It is usually slow growing and benign, and surgery is the main treatment modality. There are limited data on return to work following meningioma surgery. The objective of this study was to determine the patterns of sick-leave rate prior to surgery, and up to 2 years after, in patients compared to matched controls. Methods Data on patients ages 18 to 60 years with histologically verified intracranial meningioma between 2009 and 2015 were identified in the Swedish Brain Tumor Registry (SBTR) and linked to 3 national registries after 5 matched controls were assigned to each patient. Results We analyzed 956 patients and 4765 controls. One year prior to surgery, 79% of meningioma patients and 86% of controls were working (P < .001). The proportion of patients at work 2 years after surgery was 57%, in contrast to 84% of controls (P < .001). Statistically significant negative predictors for return to work in patients 2 years after surgery were high (vs low) tumor grade, previous history of depression, amount of sick leave in the year preceding surgery, and surgically acquired neurological deficits. Conclusion There is a considerable risk for long term sick leave 2 years after meningioma surgery. Neurological impairment following surgery was a modifiable risk factor increasing the risk for long-term sick leave. More effective treatment of depression may facilitate return to work in this patient group.
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Affiliation(s)
- Erik Thurin
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Sweden
| | - Alba Corell
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Sweden.,Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sasha Gulati
- Department of Neurosurgery, St. Olav's University Hospital, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim
| | - Anja Smits
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Neuroscience, Neurology, Uppsala University, Sweden
| | - Roger Henriksson
- Department of Radiation Science and Oncology, University Hospital, Umeå, Sweden
| | - J Bartek
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Øyvind Salvesen
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim
| | - Asgeir Store Jakola
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Sweden.,Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Neurosurgery, St. Olav's University Hospital, Trondheim, Norway
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19
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Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2011-2015. Neuro Oncol 2019; 20:iv1-iv86. [PMID: 30445539 DOI: 10.1093/neuonc/noy131] [Citation(s) in RCA: 1437] [Impact Index Per Article: 287.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, IL, USA.,Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Haley Gittleman
- Central Brain Tumor Registry of the United States, Hinsdale, IL, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Gabrielle Truitt
- Central Brain Tumor Registry of the United States, Hinsdale, IL, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Alexander Boscia
- Central Brain Tumor Registry of the United States, Hinsdale, IL, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, IL, USA
| | - Jill S Barnholtz-Sloan
- Central Brain Tumor Registry of the United States, Hinsdale, IL, USA.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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20
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Lemée JM, Corniola MV, Da Broi M, Schaller K, Meling TR. Early Postoperative Complications in Meningioma: Predictive Factors and Impact on Outcome. World Neurosurg 2019; 128:e851-e858. [DOI: 10.1016/j.wneu.2019.05.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
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21
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Wang J, Zuo J, Wahafu A, Wang MD, Li RC, Xie WF. Combined elevation of TRIB2 and MAP3K1 indicates poor prognosis and chemoresistance to temozolomide in glioblastoma. CNS Neurosci Ther 2019; 26:297-308. [PMID: 31318172 PMCID: PMC7053231 DOI: 10.1111/cns.13197] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/27/2019] [Accepted: 07/03/2019] [Indexed: 01/09/2023] Open
Abstract
Introduction Glioblastoma (GBM) is the most lethal primary malignant brain tumor in adults with poor survival due to acquired therapeutic resistance and rapid recurrence. Currently, the standard clinical strategy for glioma includes maximum surgical resection, radiotherapy, and temozolomide (TMZ) chemotherapy; however, the median survival of patients with GBM remains poor despite these comprehensive therapies. Therefore, the identification of new prognostic biomarkers is urgently needed to evaluate the malignancy and long‐term outcome of glioma. Aims To further investigate prognostic biomarkers and potential therapeutic targets for GBM. Results In this study, we identified tribbles pseudokinase 2 (TRIB2) as one of the genes that is most correlated with pathological classification, radioresistance, and TMZ resistance in glioma. Additionally, the expression of mitogen‐activated protein kinase kinase kinase 1 (MAP3K1) showed a strong correlation with TRIB2. Moreover, a combined increase in TRIB2 and MAP3K1 was observed in GBM and indicated a poor prognosis of patients with glioma. Finally, enriched TRIB2 expression and MAP3K1 expression were shown to be associated with resistance to TMZ and radiotherapy. Conclusion Combined elevation of TRIB2 and MAP3K1 could be novel prognostic biomarkers and potential therapeutic targets to evaluate the malignancy and long‐term outcomes of GBM.
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Affiliation(s)
- Jia Wang
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center of Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jie Zuo
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Alafate Wahafu
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mao-de Wang
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center of Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Rui-Chun Li
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wan-Fu Xie
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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22
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Carstam L, Smits A, Milos P, Corell A, Henriksson R, Bartek J, Jakola AS. Neurosurgical patterns of care for diffuse low-grade gliomas in Sweden between 2005 and 2015. Neurooncol Pract 2019; 6:124-133. [PMID: 30949360 PMCID: PMC6440530 DOI: 10.1093/nop/npy023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND In the last decade, increasing evidence has evolved for early and maximal safe resection of diffuse low-grade gliomas (LGGs) regarding survival. However, changes in clinical practice are known to occur slowly and we do not know if the scientific evidence has yet resulted in changes in neurosurgical patterns of care. METHODS The Swedish Brain Tumor Registry was used to identify all patients with a first-time histopathological diagnosis of LGG between 2005 and 2015. For analysis of surgical treatment patterns, we subdivided assessed time periods into 2005-2008, 2009-2012, and 2013-2015. Population-based data on patient and disease characteristics, surgical management, and outcomes were extracted. RESULTS A total of 548 patients with diffuse World Health Organization grade II gliomas were identified: 142 diagnosed during 2005-2008, 244 during 2009-2012, and 162 during 2013-2015. Resection as opposed to biopsy was performed in 64.3% during 2005-2008, 74.2% during 2009-2012, and 74.1% during 2013-2015 (P = .08). There was no difference among the 3 periods regarding overall survival (P = .11). However, post hoc analysis of data from the 4 (out of 6) centers that covered all 3 time periods demonstrated a resection rate of 64.3% during 2005-2008, 77.4% during 2009-2012, and 75.4% during 2013-2015 (P = .02) and longer survival of patients diagnosed 2009 and onward (P = .04). CONCLUSION In this nationwide, population-based study we observed a shift over time in favor of LGG resection. Further, a positive correlation between the more active surgical strategy and longer survival is shown, although no causality can be claimed because of possible confounding factors.
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Affiliation(s)
- Louise Carstam
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Sweden
| | - Anja Smits
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Sweden
- Department of Neuroscience, Neurology, Uppsala University, University Hospital, Sweden
| | - Peter Milos
- Department of Neurosurgery, Linköping University Hospital, Sweden
| | - Alba Corell
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Roger Henriksson
- Regional Cancer Centre Stockholm Gotland, Stockholm, Sweden
- Department of Radiation Sciences & Oncology, University of Umeå, Sweden
| | - Jiri Bartek
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
- Department of Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Asgeir Store Jakola
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Sweden
- Department of Neurosurgery, St. Olavs University Hospital HF, Trondheim, Norway
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23
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Eriksson M, Kahari J, Vestman A, Hallmans M, Johansson M, Bergenheim AT, Sandström M. Improved treatment of glioblastoma - changes in survival over two decades at a single regional Centre. Acta Oncol 2019; 58:334-341. [PMID: 30732527 DOI: 10.1080/0284186x.2019.1571278] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Glioblastoma (GBM) is an aggressive brain tumor with a short overall survival (OS) in general. The treatment of GBM has evolved over the last decades and is today multimodal including surgical resection followed by radiochemotherapy and adjuvant chemotherapy for patients in good performance status. The aim of this study was to evaluate the development of treatment and the outcome for GBM patients at a single regional center. PATIENTS AND METHODS Survival was studied for 571 patients in our region diagnosed with GBM between 1995 and 2015. Samples from 244 patients out of those treated 2005-2015 have been included in a tissue/blood bank and a clinical database has been set up with basic patient characteristics and details on surgery and non-surgical treatment. RESULTS The median OS for all patients from 1995 to 2015 was 9.3 months. There was a stepwise improvement from 6.9 to 10.3 months for patients diagnosed 1995-1996 and 2010-2015, respectively (p < .05). The 2-year survival for the same time periods improved from 7% to 18% (p < .01). After introduction of postoperative radiochemotherapy for patients in good performance status in 2005 an increased OS was noted and following implementation of intraoperative 5-aminolevulinic acid the number of tumor resection ≥95% did increase from 33% to 54% (p < .001). Positive prognostic factors for survival were young age, good performance status, absence of inflammatory disease, absence of diabetes or metabolic disease, tumor resection ≥95%, and completion of postoperative radiochemotherapy. DISCUSSION The results of this study are consistent with earlier results regarding survival and prognostic factors and confirm results from randomized controlled trials in a clinical setting. Despite the improvements made, the prognosis is still dismal and the need for further research on GBM treatment is great.
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Affiliation(s)
- Maria Eriksson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Jenna Kahari
- Department of Clinical Neuroscience, Neurosurgery, Umeå University, Umeå, Sweden
| | - Amanda Vestman
- Department of Clinical Neuroscience, Neurosurgery, Umeå University, Umeå, Sweden
| | - Mattias Hallmans
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Mikael Johansson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - A. Tommy Bergenheim
- Department of Clinical Neuroscience, Neurosurgery, Umeå University, Umeå, Sweden
| | - Maria Sandström
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
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Corell A, Thurin E, Skoglund T, Farahmand D, Henriksson R, Rydenhag B, Gulati S, Bartek J, Jakola AS. Neurosurgical treatment and outcome patterns of meningioma in Sweden: a nationwide registry-based study. Acta Neurochir (Wien) 2019; 161:333-341. [PMID: 30675656 PMCID: PMC6373228 DOI: 10.1007/s00701-019-03799-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 01/04/2019] [Indexed: 11/07/2022]
Abstract
Background Surgery is the main treatment modality for intracranial meningiomas, but data on short-term surgical outcome are limited. The aim of this Swedish nationwide registry-based study was to benchmark the 30-day complication rate in a cohort of meningioma patients using data from the Swedish brain tumor registry (SBTR). Furthermore, we investigated outcomes for asymptomatic patients. Methods Data were collected from the SBTR for all adults with histopathologically verified intracranial meningioma between 2009 and 2015. Patient symptoms, tumor characteristics, and complications within 30 days postoperatively were analyzed. Results In total, 2324 patients, with a mean age of 58.7 years (SD 13.5), underwent surgery for intracranial meningioma and 14.1% of the patients were asymptomatic before the intervention. The most common symptom prior to treatment was focal deficit, which occurred in 1450 patients (62.4%). Moreover, within 30 days after surgery, 344 patients (14.8%) developed new neurological deficits and new-onset seizures occurred in 105 patients (4.5%), while 8.3% of asymptomatic patients developed neurological deficit and 3.7% new-onset seizures. Due to complications, reoperations were performed in 120 patients (5.2%). The postoperative 30-day mortality in the whole cohort was 1.5%. Conclusion This study benchmarks the 30-day complication rate after meningioma surgery and provides outcome data in the highly relevant group of asymptomatic patients using data from the Swedish brain tumor registry. Since surgical decision-making is a careful consideration of short-term risk versus long-term benefit, this information may be useful for both caregivers and patients.
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25
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Bartek J, Förander P, Thurin E, Wangerid T, Henriksson R, Hesselager G, Jakola AS. Short-Term Surgical Outcome for Vestibular Schwannoma in Sweden: A Nation-Wide Registry Study. Front Neurol 2019; 10:43. [PMID: 30761075 PMCID: PMC6361837 DOI: 10.3389/fneur.2019.00043] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/14/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Vestibular Schwannoma (VS) is a benign neoplasm arising from the 8th cranial nerve, with surgery one of the treatment modalities. In a nation-wide registry study, we describe the baseline, treatment characteristics, and short-term outcome in patients surgically treated for VS. Methods: We performed a nationwide study with data from the Swedish Brain Tumor Registry (SBTR) for all adults diagnosed with VS 2009–2015. Patient symptoms, tumor characteristics, and postoperative complications were analyzed. Results: In total 348 patients underwent surgery for VS. Mean age was 50.6 ± 14.5 years and 165 patients (47.4%) were female. The most common symptom was focal neurological deficit (92.0%), with only 25 (7.2%) being asymptomatic prior to surgery, and 217 (63.6%) had no restriction in activity. Following surgery, 100 (28.7%) patients developed new deficit(s). In terms of postoperative complications; 11 (3.2%) had a hematoma, 35 (10.1%) an infection, 10 (2.9%) a venous thromboembolism, and 23 (6.6%) had a reoperation due to complication. There were no deaths within 30-days after surgery. When grouped according to tumor size (< 4 vs. ≥4 cm), those with ≥4 cm tumors were more often males (p = 0.02), had more often ICP related symptoms (p = 0.03) and shorter time from imaging to surgery (p < 0.01). Analysis of the younger (< 65 years) vs. elderly (≥65 years) revealed no difference in outcome except increased 1-year mortality (p = 0.002) in elderly. Conclusion: In this nation-wide registry-study, we benchmark the 30-day complication rate after VS surgery as collected by the SBTR. Further, we present the current neurosurgical outcome data from both VS smaller than 40 mm compared to larger tumors, as well as younger vs. elderly VS patients. Since surgical decision making is a careful consideration of short term risk vs. long term benefit, this information can be useful in clinical decision making.
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Affiliation(s)
- Jiri Bartek
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Petter Förander
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Thurin
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Theresa Wangerid
- Department of Neurology, Capio St. Göran Hospital, Stockholm, Sweden
| | - Roger Henriksson
- Regional Cancer Centre Stockholm/Gotland, Stockholm, Sweden.,Department of Radiation Sciences and Oncology, University of Umeå, Umeå, Sweden
| | - Göran Hesselager
- Department of Neurosurgery, Uppsala University Hospital, Uppsala, Sweden
| | - Asgeir Store Jakola
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway
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26
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Sjöström O, Silander G, Syk I, Henriksson R, Melin B, Hellquist BN. Disparities in colorectal cancer between Northern and SouthernSweden - a report from the new RISK North database. Acta Oncol 2018; 57:1622-1630. [PMID: 30280619 DOI: 10.1080/0284186x.2018.1497300] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Geographic cancer health disparities have been reported in Sweden. The disparities are not fully understood, but may be attributed to differences in exposure to risk factors as well as differences in health care, socioeconomics and demography. The aim of this study was to describe the new nationwide population based RISK North database and its potential by analysing health disparities in colorectal cancer between Northern and Southern Sweden. METHODS Cancer-specific data from the National Cancer Quality Registers for colorectal, gastric and oesophageal cancer and brain tumours were linked to several nationwide registers hereby creating a new database - RISK North. To exemplify the potential of RISK North, we analyzed differences in colorectal cancer incidence, mortality and survival in relation to gender, age, cohabitation and education between Northern and Southern Sweden 2007-2013. RESULTS In colon cancer, the age-adjusted incidence per 100.000 was lower in Northern than Southern Sweden, 35.9 in the North vs. 41.1 in the South (p < .01); mortality rates were 11.0 vs. 12.2 (p < .01). For rectal cancer, incidence rates were 17.6 vs. 19.7 (p < .01) and mortality rates 5.33 vs. 5.89 (p = .07), respectively. The largest difference in incidence was demonstrated for colon cancer among individuals >79 years old (190. vs. 237, i.e., ∼20%). Survival in colon cancer was higher in Southern Sweden, HR 0.92 (0.87-0.98) adjusted for age, gender, co-habiting, education and m-stage at diagnosis. No difference in survival was seen for rectal cancer. CONCLUSIONS The new RISK North database enabled analysis of cancer disparities between Northern and Southern Sweden. The incidence of colorectal cancer were lower in the North of Sweden whereas colon cancer survival was higher in the South. These differences can be further analysed utilising the RISK North database.
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Affiliation(s)
- Olof Sjöström
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Gustav Silander
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Ingvar Syk
- Lund University, Lund, Sweden
- Department of Surgery, Skåne University Hospital, Malmö, Sweden
| | - Roger Henriksson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Beatrice Melin
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
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Ostrom QT, Gittleman H, Xu J, Kromer C, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2009-2013. Neuro Oncol 2018; 18:v1-v75. [PMID: 28475809 DOI: 10.1093/neuonc/now207] [Citation(s) in RCA: 817] [Impact Index Per Article: 136.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Quinn T Ostrom
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH USA.,Central Brain Tumor Registry of the United States, Hinsdale, IL USA
| | - Haley Gittleman
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH USA.,Central Brain Tumor Registry of the United States, Hinsdale, IL USA
| | - Jordan Xu
- Case Western Reserve University School of Medicine , Cleveland, OHUSA
| | | | - Yingli Wolinsky
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH USA.,Central Brain Tumor Registry of the United States, Hinsdale, IL USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States , Hinsdale, ILUSA
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH USA.,Central Brain Tumor Registry of the United States, Hinsdale, IL USA
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28
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Corell A, Carstam L, Smits A, Henriksson R, Jakola AS. Age and surgical outcome of low-grade glioma in Sweden. Acta Neurol Scand 2018; 138:359-368. [PMID: 29900547 DOI: 10.1111/ane.12973] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Low-grade gliomas (LGG) are slow-growing primary brain tumors that typically affect young adults. Advanced age is widely recognized as a poor prognostic factor in LGG. The impact of age on postoperative outcome in this patient group has not been systemically studied. METHODS We performed a nationwide register-based study with data from the Swedish Brain Tumor Registry (SBTR) for all adults diagnosed with a supratentorial LGG (WHO grade II astrocytoma, oligoastrocytoma, or oligodendroglioma) during 2005-2015. Patient- and tumor-related characteristics, postoperative complications, and survival were compared between three different age groups (18-39 years, 40-59 years, and ≥60 years). RESULTS We identified 548 patients; 204 patients (37.2%) aged 18-39 years, 227 patients (41.4%) aged 40-59 years, and 117 patients (21.4%) ≥60 years of age. Unfavorable preoperative prognostic factors (eg, functional status and neurological deficit) were more common with increased age (P < .001). In addition, overall survival was significantly impaired in those 60 years and above (P < .001). We observed a clear dose-response for age with separation of survival curves at 50 years. Biopsy was more common in patients ≥60 years (P < .001). Subgroup analysis of patients with resection revealed a higher amount of postoperative neurological deficits in older patients (P = .029). CONCLUSION In general, older patients with LGG have several unfavorable prognostic factors compared with younger patients but seem to tolerate surgery in a comparable fashion. However, more neurological deficits were observed following resections in elderly. Our data further support a cutoff at 50 years rather than 40 years for selection of high-risk patients.
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Affiliation(s)
- A. Corell
- Department of Neurosurgery; Sahlgrenska University Hospital; Gothenburg Sweden
- Institute of Neuroscience and Physiology; University of Gothenburg; Sahlgrenska Academy; Gothenburg Sweden
| | - L. Carstam
- Department of Neurosurgery; Sahlgrenska University Hospital; Gothenburg Sweden
- Institute of Neuroscience and Physiology; University of Gothenburg; Sahlgrenska Academy; Gothenburg Sweden
| | - A. Smits
- Institute of Neuroscience and Physiology; University of Gothenburg; Sahlgrenska Academy; Gothenburg Sweden
- Department of Neuroscience, Neurology; Uppsala University; Uppsala Sweden
| | - R. Henriksson
- Regional Cancer Centre Stockholm; Gotland Sweden
- Department of Radiation Science and Oncology; University hospital; Umeå Sweden
| | - A. S. Jakola
- Department of Neurosurgery; Sahlgrenska University Hospital; Gothenburg Sweden
- Institute of Neuroscience and Physiology; University of Gothenburg; Sahlgrenska Academy; Gothenburg Sweden
- Department of Neurosurgery; St. Olavs University Hospital; Trondheim Norway
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Bruhn H, Strandéus M, Milos P, Hallbeck M, Vrethem M, Lind J. Improved survival of Swedish glioblastoma patients treated according to Stupp. Acta Neurol Scand 2018; 138:332-337. [PMID: 29882211 DOI: 10.1111/ane.12966] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The median survival in glioblastoma (GBM) patients used to be less than 1 year. Surgical removal of the tumor with subsequent concomitant radiation/temozolomide (the Stupp regimen) has been shown to prolong survival. The Stupp protocol was implemented in the county of Jönköping in 2006. The purpose of this study was to examine if the Stupp treatment has prolonged overall survival, in an unselected patient cohort with histologically verified GBM. MATERIAL AND METHOD This study includes all patients from the county of Jönköping, with a diagnosis of GBM from January 2001 to December 2012. Patients were divided into 2 cohorts, 2001-2005 and 2006-2012, that is before and after implementation of the Stupp regimen. By reviewing the medical case notes, the dates of the histological diagnosis and of death were identified. The median and mean overall survival and Kaplan-Meier survival analysis were calculated and compared between the 2 cohorts. RESULTS The mean survival was 110 days longer in the cohort treated according to the Stupp regimen. Four patients in the 2006-2012 cohort and 1 patient in the 2001-2005 cohort are still alive. When comparing survival in patients with radical surgery vs biopsy, those that underwent radical surgery survived longer. The significance was slightly greater in the 2001-2005 cohort (mean 163 vs 344 days, P < .001) than in the 2006-2012 cohort (mean 220 vs 397 days, P = .02). CONCLUSION Survival significantly improved after the implementation of the Stupp regimen in the study region of Sweden.
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Affiliation(s)
- H. Bruhn
- Section of Neurology; Department of Internal Medicine; County Hospital Ryhov; Jönköping Sweden
| | - M. Strandéus
- Department of Oncology; County Hospital Ryhov; Jönköping Sweden
| | - P. Milos
- Department of Neurosurgery; Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - M. Hallbeck
- Department of Pathology; Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - M. Vrethem
- Department of Neurology; Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Jonas Lind
- Section of Neurology; Department of Internal Medicine; County Hospital Ryhov; Jönköping Sweden
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
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30
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Bergqvist J, Iderberg H, Mesterton J, Henriksson R. The effects of clinical and sociodemographic factors on survival, resource use and lead times in patients with high-grade gliomas: a population-based register study. J Neurooncol 2018; 139:599-608. [PMID: 29846896 PMCID: PMC6132971 DOI: 10.1007/s11060-018-2899-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 05/05/2018] [Indexed: 11/24/2022]
Abstract
Background Previous studies indicate an effect of sociodemographic factors on risk for being diagnosed with, as well as on survival of cancer in general. Our primary aim was to analyse sociodemographic factors, resource use and lead times in health care after diagnosis with high grade malignant glioma (HGG) in a large population based cohort. Methods A register-based study using several unique high-coverage registries. All patients over the age of 18 diagnosed with HGG in the Swedish Stockholm–Gotland region between 2001 and 2013 (n = 1149) were included. Results In multivariable cox proportional hazard model of survival, older age, male sex and high tumour grade were associated with worse survival. No significant differences could be seen related to country of birth. A high disposable income was associated with better survival and fewer occasions of pre-diagnostic inpatient care. Older age and comorbidities were correlated with a significantly increased number of outpatient visits the year before HGG diagnosis. In addition, male sex, being born outside Sweden was associated to a higher number of outpatient visits the year after diagnosis in multivariable analysis. Leadtime from diagnosis (first suspicion on brain scan) to surgery showed that the oldest patients, patients with comorbidity and patients born outside Europe had to wait longer for surgery. Conclusions Sociodemographic factors like education, income and country of birth have impact on care processes both before and after the diagnosis HGG. This needs to be acknowledged in addition to important clinical factors like age, comorbidity and tumour grade, in order to accomplish more equal cancer care.
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Affiliation(s)
- Jenny Bergqvist
- Institution of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden. .,Capio St Görans Hospital, St Görans plan 1, 112 81, Stockholm, Sweden.
| | - Hanna Iderberg
- Ivbar Institute AB, Hantverkargatan 8, Stockholm, Sweden.,Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Johan Mesterton
- Ivbar Institute AB, Hantverkargatan 8, Stockholm, Sweden.,Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Roger Henriksson
- Regional Cancer Centre Stockholm Gotland, Stockholm County Council, Stockholm, Sweden.,Department of Radiation Sciences and Oncology, University of Umeå, Umeå, Sweden
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Hansen S, Rasmussen BK, Laursen RJ, Kosteljanetz M, Schultz H, Nørgård BM, Guldberg R, Gradel KO. Treatment and survival of glioblastoma patients in Denmark: The Danish Neuro-Oncology Registry 2009-2014. J Neurooncol 2018; 139:479-489. [PMID: 29754199 DOI: 10.1007/s11060-018-2892-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/03/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND As many glioblastoma patients are in a poor condition they are unable to undergo the full treatment documented in clinical trials. We aimed to examine the survival and its relationship to clinical characteristics and treatment in a nationwide population of glioblastoma patients in Denmark. METHODS We included prospectively recorded clinical data from 1364 adult patients with histologically verified glioblastoma from the Danish Neuro-Oncology Registry, 2009-2014. RESULTS The age standardized incidence rate was 6.3/100,000 person-years for males and 3.9 for females and the median age was 66 years. The median overall survival was 11.2 months. There was an independently significant prognostic effect of age, performance status, cognitive symptoms, tumor diameter, multifocality, crossing midline, and contrast enhancement. For partial and total resection compared to biopsy only, the adjusted risk of dying was reduced by 43% (HR [CI] 0.57 [0.48-0.68]) and 51% (0.49 [0.40-0.60]), respectively. For patients receiving a partial and full radiochemotherapy regimen compared to no postsurgical treatment, the risk reduction was 56% (HR [CI] 0.44 [0.37-0.53]) and 70% (0.30 [0.25-0.35]), respectively. The full radiochemotherapy regimen was only allocated to 50% of the patients, 29% among the oldest (70+ years) and 60% among the younger (18-69 years). CONCLUSIONS Glioblastoma patients had a poor overall survival but with several specific independent prognostic factors. Extensive cancer treatment was associated with an increasing survival in all age groups, but only half of the patients were sufficiently fit for a full regimen of postoperative combined radiochemotherapy.
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Affiliation(s)
- Steinbjørn Hansen
- Department of Oncology, Odense University Hospital, Odense, Denmark. .,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | | | | | | | - Henrik Schultz
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Mertz Nørgård
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
| | - Rikke Guldberg
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
| | - Kim Oren Gradel
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
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Mwita CC, Rowland T, Gwer S. Burden of brain tumors in low- and middle-income countries: a systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2018; 16:609-614. [PMID: 29521859 DOI: 10.11124/jbisrir-2017-003424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this review is to determine the best available evidence on the burden of brain tumors in low- and middle-income countries (LAMICs). More specifically, the objective is to determine the incidence and prevalence rates for brain tumors in LAMICs.
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Affiliation(s)
- Clifford C Mwita
- School of Medicine, Moi University, Eldoret, Kenya
- Afya Research Africa (ARA): a Joanna Briggs Institute Centre of Excellence
| | - Thabo Rowland
- School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Samson Gwer
- School of Medicine, Kenyatta University, Nairobi, Kenya
- Afya Research Africa (ARA): a Joanna Briggs Institute Centre of Excellence
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Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014. Neuro Oncol 2017; 19:v1-v88. [PMID: 29117289 PMCID: PMC5693142 DOI: 10.1093/neuonc/nox158] [Citation(s) in RCA: 1088] [Impact Index Per Article: 155.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Quinn T Ostrom
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA; Boston University, Boston, MA, USA
| | - Haley Gittleman
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA; Boston University, Boston, MA, USA
| | - Peter Liao
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA; Boston University, Boston, MA, USA
| | - Toni Vecchione-Koval
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA; Boston University, Boston, MA, USA
| | - Yingli Wolinsky
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA; Boston University, Boston, MA, USA
| | - Carol Kruchko
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA; Boston University, Boston, MA, USA
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Central Brain Tumor Registry of the United States, Hinsdale, IL, USA; Boston University, Boston, MA, USA
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34
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Fuentes-Raspall R, Solans M, Roca-Barceló A, Vilardell L, Puigdemont M, Del Barco S, Comas R, García-Velasco A, Astudillo A, Carmona-Garcia MC, Marcos-Gragera R. Descriptive epidemiology of primary malignant and non-malignant central nervous tumors in Spain: Results from the Girona Cancer Registry (1994-2013). Cancer Epidemiol 2017; 50:1-8. [PMID: 28738268 DOI: 10.1016/j.canep.2017.07.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/15/2017] [Accepted: 07/06/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Systematic registration of non-malignant central nervous system (CNS) tumors is a rare practice among European cancer registries. Thus, the real burden of all CNS tumors across Europe is underestimated. The Girona Cancer Registry provides here the first data on CNS tumor incidence and survival trends in Spain for all histological types, including malignant and non-malignant tumors. METHODS Data on all incident cases of primary CNS tumors notified to the Girona population-based cancer registry from 1994 to 2013 (n=2,131) were reviewed. Incidences rates (IRs) were standardized to the 2013 European population and annual percentage changes (EAPC) were estimated using a piecewise log linear model. 1- and 5-year observed (OS) and relative survival (RS) were also calculated. Results were expressed by sex, age-group, histological subtype and behavior. RESULTS The overall IR was 16.85 and increased across the period of study (EAPC=+2.2%). The proportion and IRs of malignant (50.2%; IR=9.35) and non-malignant cases (49.8%; IR=9.14) were similar; however, non-malignant tumors were more frequent in women (sex ratio=0.63). The most frequently reported histologies were meningioma (27.6%; IR=5.11) and glioblastoma (22.2%; IR=4.15), which also accounted for the highest and lowest 5-year RS (80.2%; 3.7%, respectively). Globally, 5-year RS was lower in men (42.6% vs. 58.3%, respectively) and in the elderly (64.9% for 0-14years vs. 23.0% for >74years). CONCLUSION This study presents a comprehensive overview of the epidemiology of malignant and non-malignant CNS primary tumors from the well-established region-wide Girona Cancer Registry (1994-2013). Incidence rates were recovered for all histologies. Survival is still dramatically associated to both age and histological subtype.
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Affiliation(s)
- Rafael Fuentes-Raspall
- Radiation Oncology Service, Josep Trueta University Hospital, Catalan Institute of Oncology, Avinguda de França, S/N, 17007 Girona, Spain.
| | - Marta Solans
- CIBER in Epidemiology and Public Health (CIBERESP), University of Girona (UdG), C/ Universitat de Girona 10,17003 Girona, Spain, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona (UdG), C/ Universitat de Girona 10,17003 Girona, Spain; Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
| | - Aina Roca-Barceló
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
| | - Loreto Vilardell
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
| | - Montse Puigdemont
- Hospital Cancer Registry, Josep Trueta University Hospital, Catalan Institute of Oncology, Av de França, 17007, Girona, Spain; Nursing Department, University of Girona, Av de França, 17007, Girona, Spain.
| | - Sonia Del Barco
- Medical Oncology Service, Josep Trueta University Hospital, Catalan Institute of Oncology, Av de França, 17007, Girona, Spain.
| | - Raquel Comas
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
| | - Adelaida García-Velasco
- Medical Oncology Service, Josep Trueta University Hospital, Catalan Institute of Oncology, Av de França, 17007, Girona, Spain.
| | - Aurora Astudillo
- Department of Pathology, Central University Hospital of Asturias (HUCA), Av. de Roma, 33006 Oviedo, Spain.
| | - Mª Carme Carmona-Garcia
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain; Emergency Department, Josep Trueta University Hospital, Catalan Institute of Oncology, Av de França, 17007, Girona, Spain.
| | - Rafael Marcos-Gragera
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona (UdG), C/ Universitat de Girona 10,17003 Girona, Spain; Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain.
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Weller M, van den Bent M, Tonn JC, Stupp R, Preusser M, Cohen-Jonathan-Moyal E, Henriksson R, Le Rhun E, Balana C, Chinot O, Bendszus M, Reijneveld JC, Dhermain F, French P, Marosi C, Watts C, Oberg I, Pilkington G, Baumert BG, Taphoorn MJB, Hegi M, Westphal M, Reifenberger G, Soffietti R, Wick W. European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas. Lancet Oncol 2017; 18:e315-e329. [PMID: 28483413 DOI: 10.1016/s1470-2045(17)30194-8] [Citation(s) in RCA: 711] [Impact Index Per Article: 101.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 12/29/2016] [Accepted: 01/13/2017] [Indexed: 12/14/2022]
Abstract
The European Association for Neuro-Oncology guideline provides recommendations for the clinical care of adult patients with astrocytic and oligodendroglial gliomas, including glioblastomas. The guideline is based on the 2016 WHO classification of tumours of the central nervous system and on scientific developments since the 2014 guideline. The recommendations focus on pathological and radiological diagnostics, and the main treatment modalities of surgery, radiotherapy, and pharmacotherapy. In this guideline we have also integrated the results from contemporary clinical trials that have changed clinical practice. The guideline aims to provide guidance for diagnostic and management decisions, while limiting unnecessary treatments and costs. The recommendations are a resource for professionals involved in the management of patients with glioma, for patients and caregivers, and for health-care providers in Europe. The implementation of this guideline requires multidisciplinary structures of care, and defined processes of diagnosis and treatment.
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Affiliation(s)
- Michael Weller
- Department of Neurology, Brain Tumour Centre, University Hospital and University of Zurich, Zurich, Switzerland.
| | | | - Jörg C Tonn
- Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Roger Stupp
- Department of Oncology, Brain Tumour Centre, University Hospital and University of Zurich, Zurich, Switzerland
| | - Matthias Preusser
- Department of Medicine, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Elizabeth Cohen-Jonathan-Moyal
- Département de Radiotherapie, Institut Claudius Regaud, L'Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Roger Henriksson
- Regional Cancer Centre Stockholm-Gotland and Department of Radiation Sciences and Oncology, Umeå University Hospital, Umeå, Sweden
| | - Emilie Le Rhun
- Neuro-Oncology, Department of Neurosurgery, University Hospital, Lille, France
| | - Carmen Balana
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Olivier Chinot
- Department of Neuro-Oncology, Aix-Marseille Université, Assistance Publique-Hopitaux de Marseille, Centre Hospitalo-Universitaire Timone, Marseilles, France
| | - Martin Bendszus
- Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Jaap C Reijneveld
- Department of Neurology and Brain Tumour Centre Amsterdam, Vrije Universiteit Medical Centre, Amsterdam, Netherlands
| | - Frederick Dhermain
- Department of Radiotherapy, Gustave Roussy University Hospital, Villejuif, France
| | - Pim French
- Department of Neurology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Christine Marosi
- Department of Medicine, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Colin Watts
- Department of Clinical Neurosciences, Division of Neurosurgery, University of Cambridge, Cambridge, UK
| | - Ingela Oberg
- Division of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals Foundation Trust, Cambridge, UK
| | | | - Brigitta G Baumert
- Department of Radiation Oncology, MediClin Robert Janker Clinic and Clinical Cooperation Unit Neurooncology, University of Bonn Medical Centre, Bonn, Germany
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Centre and Medical Centre Haaglanden, The Hague, Netherlands
| | - Monika Hegi
- Department of Clinical Neurosciences, University Hospital Lausanne, Lausanne, Switzerland
| | - Manfred Westphal
- Department of Neurosurgery, University Hospital Hamburg, Hamburg, Germany
| | - Guido Reifenberger
- Department of Neuropathology, Heinrich Heine University Düsseldorf and German Cancer Consortium (DKTK), Essen/Düsseldorf, Germany
| | | | - Wolfgang Wick
- Neurology Clinic and National Centre for Tumour Diseases, University Hospital Heidelberg, Heidelberg, Germany; German Consortium of Translational Cancer Research (DKTK), Clinical Cooperation Unit Neurooncology, German Cancer Research Center, Heidelberg, Germany
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Bergqvist J, Iderberg H, Mesterton J, Bengtsson N, Wettermark B, Henriksson R. Healthcare resource use, comorbidity, treatment and clinical outcomes for patients with primary intracranial tumors: a Swedish population-based register study. Acta Oncol 2017; 56:405-414. [PMID: 27924653 DOI: 10.1080/0284186x.2016.1257864] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Primary intracranial tumors are relatively uncommon and heterogeneous, which make them challenging to study. We coupled data from unique Swedish population-based registries in order to deeper analyze the most common intracranical tumor types. Patient characteristics (e.g. comorbidities), care process measures like adherence to national guidelines, healthcare resource use and clinical outcome was evaluated. MATERIALS AND METHODS A register-based study including several population-based registries for all patients living in Stockholm-Gotland, diagnosed with primary intracranial tumor between 2001 and 2013 was performed. Patient characteristics were captured and investigated in relation to survival, healthcare resource use (inpatient-, outpatient- and primary care) and treatment process. RESULTS High-grade glioma and meningioma were the most common tumor types and most patients (76%) were above the age of 40 in the patient population (n = 3664). Older age, comorbidity (Elixhauser comorbidity index) and type of tumor (high-grade glioma) were associated with lower survival rate and increased use of healthcare resources, analyzed for patients living in Stockholm (n = 3031). The analyses of healthcare use and survival showed no differences between males and females, when stratifying by tumor types. Healthcare processes were not always consistent with existing national treatment recommendations for patients with high-grade gliomas (n = 474) with regard to specified lead times, analyzed in the Swedish Brain Tumor Registry, as also observed at the national level. CONCLUSIONS Age, comorbidity and high-grade gliomas, but not sex, were associated with decreased survival and increased use of healthcare resources. Fewer patients than aimed for in national guidelines received care according to specified lead times. The analysis of comprehensive population-based register data can be used to improve future care processes and outcomes.
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Affiliation(s)
- Jenny Bergqvist
- Department of Pathology and Oncology, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Capio St Görans Hospital, Stockholm, Sweden
| | - Hanna Iderberg
- Ivbar Institute, Stockholm, Sweden
- Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Johan Mesterton
- Ivbar Institute, Stockholm, Sweden
- Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | | | - Björn Wettermark
- Public Healthcare Services Committee Administration, Stockholm County Council, Stockholm, Sweden
| | - Roger Henriksson
- Regional Cancer Centre Stockholm-Gotland, Stockholm County Council, Stockholm, Sweden
- Department of Radiation Sciences and Oncology, University of Umeå, Umeå, Sweden
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Nilsson J, Holgersson G, Carlsson T, Henriksson R, Bergström S, Bergqvist M. Incidence trends in high-grade primary brain tumors in males and females. Oncol Lett 2017; 13:2831-2837. [PMID: 28454474 DOI: 10.3892/ol.2017.5770] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 12/06/2016] [Indexed: 12/24/2022] Open
Abstract
The focus of the present review is to investigate whether there is a variation in the incidence rates between male and female patients with high-grade primary brain tumors and if there are altered incidence rates associated with the time at which they were diagnosed. Previous studies identified in internationally peer-reviewed journals were identified using a systematic search of the PubMed database. Due to the difficulties in data interpretation, studies that exclusively included patient data classified prior to the 2nd edition of the World Health Organization histological classification system of brain tumors were excluded. The overall incidence rates and incidence trends of male and female patients were analyzed separately. The mean age-adjusted overall incidence rate in the male population was 1.27 per 100,000 compared with 0.89 per 100,000 in the female population. The variance between the two genders differed and a Wilcoxon rank-sum test indicated that there was no significant difference in the incidence rate of high-grade primary brain tumors between males and females (P=0.3658). Furthermore, there was no significant difference in incidence rate trend between 1996-2004 and 2005-2010 for male or female populations (P=0.101 and P=0.472, respectively). The results from the present systematic review did not demonstrate a significant difference in incidence rate between the two genders. Therefore, the results from the current study are considered to be preliminary and further studies are required to elucidate this issue.
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Affiliation(s)
- Jonas Nilsson
- Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87 Gävle, Sweden.,Department of Radiation Sciences and Oncology, Umeå University Hospital, SE-901 87 Umeå, Sweden.,Department of Radiology, Gävle Hospital, SE-801 88 Gävle, Sweden
| | - Georg Holgersson
- Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87 Gävle, Sweden.,Department of Oncology, Gävle Hospital, SE-801 88 Gävle, Sweden
| | - Tobias Carlsson
- Department of Oncology, Gävle Hospital, SE-801 88 Gävle, Sweden
| | - Roger Henriksson
- Department of Radiation Sciences and Oncology, Umeå University Hospital, SE-901 87 Umeå, Sweden.,Regional Cancer Center Stockholm-Gotland, Västgötagatan 2, SE-102 39 Stockholm, Sweden
| | - Stefan Bergström
- Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87 Gävle, Sweden.,Department of Oncology, Gävle Hospital, SE-801 88 Gävle, Sweden
| | - Michael Bergqvist
- Centre for Research and Development, Uppsala University/Region Gävleborg, SE-801 87 Gävle, Sweden.,Department of Radiation Sciences and Oncology, Umeå University Hospital, SE-901 87 Umeå, Sweden.,Department of Oncology, Gävle Hospital, SE-801 88 Gävle, Sweden
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38
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Liang F, Wang B, Bao L, Zhao YS, Zhang SM, Zhang SQ. Overexpression of ILK promotes temozolomide resistance in glioma cells. Mol Med Rep 2017; 15:1297-1304. [PMID: 28138714 DOI: 10.3892/mmr.2017.6157] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 11/29/2016] [Indexed: 11/05/2022] Open
Abstract
The present study aimed to investigate whether overexpression of integrin-linked kinase (ILK) affects drug resistance to temozolomide (TMZ) in glioma cells. To do this, a plasmid containing the ILK gene was transfected into the SHG‑44 human glioma cell line, and cells were subsequently cultured in the absence or presence of TMZ. The expression levels of ILK, multidrug resistance‑associated protein (MRP) and multi‑drug resistance protein (MDR) were assessed in these cells. Cell growth and apoptosis were measured by MTT and Hoechst staining, and flow cytometry, respectively. In addition, the expression levels of B‑cell lymphoma 2 (Bcl‑2) and Bcl‑2‑associated x protein (Bax), and caspase‑3 activity, were evaluated. The ILK‑overexpressing SHG‑44 cell was successfully constructed, and demonstrated increased expression levels of ILK, MDR and MRP compared with untransfected cells. Cell growth in the ILK+TMZ group was significantly greater, and the percentage of apoptotic cells in the ILK+TMZ group was significantly reduced, compared with the p enhanced green fluorescent protein (EGFP)‑C1+ TMZ empty vector control group. Expression levels of the anti‑apoptotic protein Bcl‑2 were significantly increased and those of the pro‑apoptotic protein Bax were significantly decreased (P<0.01) in the ILK+TMZ group compared with the pEGFP‑C1+TMZ group. In addition, the activity of caspase‑3 in ILK+TMZ group was significantly decreased compared with the pEGFP‑C1+TMZ group (P<0.01). Overexpression of ILK therefore promoted the proliferation of SHG‑44 human glioma cells, reduced apoptosis and reduced sensitivity to TMZ via decreasing the activity of caspase‑3.
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Affiliation(s)
- Feng Liang
- Department of Neurosurgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Bing Wang
- Department of Neurosurgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Long Bao
- Department of Neurosurgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Yin-Sheng Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Shi-Min Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Shu-Qin Zhang
- Department of Pediatrics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
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39
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Hansen S, Nielsen J, Laursen RJ, Rasmussen BK, Nørgård BM, Gradel KO, Guldberg R. The Danish Neuro-Oncology Registry: establishment, completeness and validity. BMC Res Notes 2016; 9:425. [PMID: 27576510 PMCID: PMC5006621 DOI: 10.1186/s13104-016-2233-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 08/19/2016] [Indexed: 11/17/2022] Open
Abstract
Background The Danish Neuro-Oncology Registry (DNOR) is a nationwide clinical cancer database that has prospectively registered data on patients with gliomas since January 2009. The purpose of this study was to describe the establishment of the DNOR and further to evaluate the database completeness of patient registration and validity of data. Methods The completeness of the number of patients registered in the database was evaluated in the study period from January 2009 through December 2014 by comparing cases reported to the DNOR with the Danish National Patient Registry and the Danish Pathology Registry. The data validity of important clinical variables was evaluated by a random sample of 100 patients from the DNOR using the medical records as reference. Results A total of 2241 patients were registered in the DNOR by December 2014 with an overall patient completeness of 92 %, which increased during the study period (from 78 % in 2009 to 96 % in 2014). Medical records were available for all patients in the validity analyses. Most variables showed a high agreement proportion (56–100 %), with a fair to good chance-corrected agreement (k = 0.43–1.0). Conclusions The completeness of patient registration was very high (92 %) and the validity of the most important patient data was good. The DNOR is a newly established national database, which is a reliable source for future scientific studies and clinical quality assessments among patients with gliomas.
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Affiliation(s)
- Steinbjørn Hansen
- Department of Oncology, Odense University Hospital, 5000, Odense, Denmark. .,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Jan Nielsen
- Center for Clinical Epidemiology, Odense University Hospital & Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - René J Laursen
- Department of Neurosurgery, Aalborg University Hospital, Aalborg, Denmark
| | - Birthe Krogh Rasmussen
- Department of Neurology, Nordsjælland Hospital, University of Copenhagen, Hillerød, Denmark
| | - Bente Mertz Nørgård
- Center for Clinical Epidemiology, Odense University Hospital & Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kim Oren Gradel
- Center for Clinical Epidemiology, Odense University Hospital & Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Rikke Guldberg
- Center for Clinical Epidemiology, Odense University Hospital & Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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40
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Gramatzki D, Dehler S, Rushing EJ, Zaugg K, Hofer S, Yonekawa Y, Bertalanffy H, Valavanis A, Korol D, Rohrmann S, Pless M, Oberle J, Roth P, Ohgaki H, Weller M. Glioblastoma in the Canton of Zurich, Switzerland revisited: 2005 to 2009. Cancer 2016; 122:2206-15. [PMID: 27088883 DOI: 10.1002/cncr.30023] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/04/2016] [Accepted: 02/16/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND A population-based analysis of patients with glioma diagnosed between 1980 and 1994 in the Canton of Zurich in Switzerland confirmed the overall poor prognosis of glioblastoma. To explore changes in outcome, registry data were reevaluated for patients diagnosed between 2005 and 2009. METHODS Patients with glioblastoma who were diagnosed between 2005 and 2009 were identified by the Zurich and Zug Cancer Registry. The prognostic significance of epidemiological and clinical data, isocitrate dehydrogenase 1 (IDH1)(R132H) mutation status, and O6 methylguanine DNA methyltransferase (MGMT) promoter methylation status was analyzed using the Kaplan-Meier method and the Cox proportional hazards model. RESULTS A total of 264 patients with glioblastoma were identified, for an annual incidence of 3.9 compared with the previous incidence of 3.7. The mean age of the patients at the time of diagnosis was 59.5 years in the current cohort compared with 61.3 years previously. The overall survival (OS) rate was 46.4% at 1 year, 22.5% at 2 years, and 14.4% at 3 years in the current study compared with 17.7% at 1 year, 3.3% at 2 years, and 1.2% at 3 years as reported previously. The median OS for all patients with glioblastoma was 11.5 months compared with 4.9 months in the former patient population. The median OS was 1.9 months for best supportive care, 6.2 months for radiotherapy alone, 6.7 months for temozolomide alone, and 17.0 months for radiotherapy plus temozolomide. Multivariate analysis revealed age, Karnofsky performance score, extent of tumor resection, first-line treatment, year of diagnosis, and MGMT promoter methylation status were associated with survival in patients with IDH1(R132H) -nonmutant glioblastoma. CONCLUSIONS The OS of patients newly diagnosed with glioblastoma in the Canton of Zurich in Switzerland markedly improved from 1980 through 1994 to 2005 through 2009. Cancer 2016;122:2206-15. © 2016 American Cancer Society.
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Affiliation(s)
- Dorothee Gramatzki
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Silvia Dehler
- Zurich and Zug Cancer Registry, University Hospital Zurich, Zurich, Switzerland
| | | | - Kathrin Zaugg
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - Silvia Hofer
- Department of Oncology, University Hospital Zurich, Zurich, Switzerland
| | - Yasuhiro Yonekawa
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
| | - Helmut Bertalanffy
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
| | - Anton Valavanis
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Dimitri Korol
- Zurich and Zug Cancer Registry, University Hospital Zurich, Zurich, Switzerland
| | - Sabine Rohrmann
- Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Miklos Pless
- Department of Oncology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Joachim Oberle
- Department of Neurosurgery, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Patrick Roth
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Hiroko Ohgaki
- International Agency for Research on Cancer, Lyon, France
| | - Michael Weller
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
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41
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Späth F, Andersson U, Dahlin AM, Langseth H, Hovig E, Johannesen TB, Grankvist K, Björkblom B, Wibom C, Melin B. Pre-diagnostic serum levels of EGFR and ErbB2 and genetic glioma risk variants: a nested case-control study. Tumour Biol 2016; 37:11065-72. [PMID: 26906551 PMCID: PMC4999462 DOI: 10.1007/s13277-015-4742-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 12/27/2015] [Indexed: 11/29/2022] Open
Abstract
Genetic variants have been associated with the risk of developing glioma, but functional mechanisms on disease phenotypic traits remain to be investigated. One phenotypic trait of glioblastoma is the mutation and amplification of the epidermal growth factor receptor (EGFR) gene. We investigated associations between pre-diagnostic serum protein concentrations of EGFR and ErbB2, both members of the EGFR family, and future risk of glioma. Further, we studied if EGFR glioma risk variants were associated with EGFR and ErbB2 serum levels. We assessed the associations between genetic glioma risk variants and serum concentrations of EGFR and ErbB2, as measured in pre-diagnostic cohort serum samples of 593 glioma patients and 590 matched cancer-free controls. High serum EGFR and ErbB2 levels were associated with risk of developing glioblastoma (P = 0.008; OR = 1.58, 95 % CI = 1.13–2.22 and P = 0.017, OR = 1.63, 95 % CI = 1.09–2.44, respectively). High serum ErbB2 concentration was also associated with glioma risk overall (P = 0.049; OR = 1.39, 95 % CI = 1.00–1.93). Glioma risk variants were not associated with high serum protein abundance. In contrast, the EGFR risk variant rs4947986 (T) was correlated with decreased EGFR serum levels (study cohort P = 0.024 and controls P = 0.009). To our knowledge, this is the first study showing an association of EGFR and ErbB2 serum levels with glioma more than a decade before diagnosis, indicating that EGFR and ErbB2 serum proteins are important in early gliomagenesis. However, we did not find evidence that glioma risk variants were associated with high pre-diagnostic serum concentrations of EGFR and ErbB2.
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Affiliation(s)
- Florentin Späth
- Department of Radiation Sciences, Umeå University, 901 87, Umeå, Sweden. .,Department of Oncology, Umeå University, 901 87, Umeå, Sweden.
| | - Ulrika Andersson
- Department of Radiation Sciences, Umeå University, 901 87, Umeå, Sweden.,Department of Oncology, Umeå University, 901 87, Umeå, Sweden
| | - Anna M Dahlin
- Department of Radiation Sciences, Umeå University, 901 87, Umeå, Sweden.,Department of Oncology, Umeå University, 901 87, Umeå, Sweden.,Computational Life Science Cluster (CLiC), Umeå University, 901 87, Umeå, Sweden
| | - Hilde Langseth
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Eivind Hovig
- Department of Informatics, University of Oslo, Oslo, Norway.,Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
| | - Tom Børge Johannesen
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, 901 85, Umeå, Sweden
| | - Benny Björkblom
- Department of Chemistry, Umeå University, 901 87, Umeå, Sweden
| | - Carl Wibom
- Department of Radiation Sciences, Umeå University, 901 87, Umeå, Sweden.,Department of Oncology, Umeå University, 901 87, Umeå, Sweden.,Computational Life Science Cluster (CLiC), Umeå University, 901 87, Umeå, Sweden
| | - Beatrice Melin
- Department of Radiation Sciences, Umeå University, 901 87, Umeå, Sweden.,Department of Oncology, Umeå University, 901 87, Umeå, Sweden
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42
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Has the survival of patients with glioblastoma changed over the years? Br J Cancer 2015; 114:146-50. [PMID: 26671748 PMCID: PMC4815808 DOI: 10.1038/bjc.2015.421] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 08/01/2015] [Accepted: 11/01/2015] [Indexed: 11/21/2022] Open
Abstract
Background: 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). Methods: 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. Results: 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. Conclusions: 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.
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