Patterns of management and outcomes of unifocal versus multifocal glioblastoma

Research output: Contribution to journalArticle

Background: Glioblastoma (GBM) presents as a solitary lesion (unifocal), or as multiple discrete lesions (multifocal). Multifocal GBM may have a worse prognosis as compared to unifocal GBM, but existing data are limited to small institutional series. The purpose of the present study was to evaluate demographic and clinical characteristics of patients with unifocal versus multifocal GBM to highlight demographic differences and clinical outcomes for two groups of patients. Methods: The National Cancer Database (NCDB) was queried (2004–2016) for patients newly diagnosed with either unifocal or multifocal GBM. Statistics included Kaplan-Meier overall survival (OS) analysis, along with Cox proportional hazards modeling. Results: Of 45,268 total patients, 37,483 (82.8%) had unifocal GBM and 7,785 (17.2%) had multifocal GBM. Patients with unifocal GBM more frequently received gross total resection (GTR) (41.2% versus 25.8%, p < 0.001) and conventionally fractionated radiation therapy (RT) (48.2% versus 42.7%, p < 0.001). Patients with multifocal GBM had a higher rate of surgery with biopsy only (34.0% compared to 24.1%, p < 0.001). Median OS was 12.8 months versus 8.3 months (p < 0.001) for patients with unifocal GBM or multifocal GBM, respectively. On multivariate analysis, factors associated with improved OS included unifocal disease, MGMT methylation, RT use, and chemotherapy use. Conclusions: This is the largest study to date describing outcomes for patients with multifocal GBM, and it shows that multifocal GBM is associated with a decreased use both of GTR and conventionally fractionated RT, as well as worse median OS. Further research is needed to improve clinical outcomes for patients with multifocal GBM.

Original languageEnglish (US)
Pages (from-to)155-159
Number of pages5
JournalJournal of Clinical Neuroscience
Volume74
DOIs
StatePublished - Apr 1 2020

PMID: 32089384

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Patterns of management and outcomes of unifocal versus multifocal glioblastoma. / Haque, Waqar; Thong, Yvonne; Verma, Vivek; Rostomily, Robert; Butler, E. Brian; Teh, Bin S.

In: Journal of Clinical Neuroscience, Vol. 74, 01.04.2020, p. 155-159.

Research output: Contribution to journalArticle

Harvard

Haque, W, Thong, Y, Verma, V, Rostomily, R, Butler, EB & Teh, BS 2020, 'Patterns of management and outcomes of unifocal versus multifocal glioblastoma' Journal of Clinical Neuroscience, vol. 74, pp. 155-159. https://doi.org/10.1016/j.jocn.2020.01.086

APA

Haque, W., Thong, Y., Verma, V., Rostomily, R., Butler, E. B., & Teh, B. S. (2020). Patterns of management and outcomes of unifocal versus multifocal glioblastoma. Journal of Clinical Neuroscience, 74, 155-159. https://doi.org/10.1016/j.jocn.2020.01.086

Vancouver

Haque W, Thong Y, Verma V, Rostomily R, Butler EB, Teh BS. Patterns of management and outcomes of unifocal versus multifocal glioblastoma. Journal of Clinical Neuroscience. 2020 Apr 1;74:155-159. https://doi.org/10.1016/j.jocn.2020.01.086

Author

Haque, Waqar ; Thong, Yvonne ; Verma, Vivek ; Rostomily, Robert ; Butler, E. Brian ; Teh, Bin S. / Patterns of management and outcomes of unifocal versus multifocal glioblastoma. In: Journal of Clinical Neuroscience. 2020 ; Vol. 74. pp. 155-159.

BibTeX

@article{3b46853c94884139a511c0095fce5589,
title = "Patterns of management and outcomes of unifocal versus multifocal glioblastoma",
abstract = "Background: Glioblastoma (GBM) presents as a solitary lesion (unifocal), or as multiple discrete lesions (multifocal). Multifocal GBM may have a worse prognosis as compared to unifocal GBM, but existing data are limited to small institutional series. The purpose of the present study was to evaluate demographic and clinical characteristics of patients with unifocal versus multifocal GBM to highlight demographic differences and clinical outcomes for two groups of patients. Methods: The National Cancer Database (NCDB) was queried (2004–2016) for patients newly diagnosed with either unifocal or multifocal GBM. Statistics included Kaplan-Meier overall survival (OS) analysis, along with Cox proportional hazards modeling. Results: Of 45,268 total patients, 37,483 (82.8{\%}) had unifocal GBM and 7,785 (17.2{\%}) had multifocal GBM. Patients with unifocal GBM more frequently received gross total resection (GTR) (41.2{\%} versus 25.8{\%}, p < 0.001) and conventionally fractionated radiation therapy (RT) (48.2{\%} versus 42.7{\%}, p < 0.001). Patients with multifocal GBM had a higher rate of surgery with biopsy only (34.0{\%} compared to 24.1{\%}, p < 0.001). Median OS was 12.8 months versus 8.3 months (p < 0.001) for patients with unifocal GBM or multifocal GBM, respectively. On multivariate analysis, factors associated with improved OS included unifocal disease, MGMT methylation, RT use, and chemotherapy use. Conclusions: This is the largest study to date describing outcomes for patients with multifocal GBM, and it shows that multifocal GBM is associated with a decreased use both of GTR and conventionally fractionated RT, as well as worse median OS. Further research is needed to improve clinical outcomes for patients with multifocal GBM.",
keywords = "Glioblastoma, Multifocal GBM, Radiation therapy, Unifocal GBM",
author = "Waqar Haque and Yvonne Thong and Vivek Verma and Robert Rostomily and Butler, {E. Brian} and Teh, {Bin S.}",
year = "2020",
month = "4",
day = "1",
doi = "10.1016/j.jocn.2020.01.086",
language = "English (US)",
volume = "74",
pages = "155--159",
journal = "Journal of Clinical Neuroscience",
issn = "0967-5868",
publisher = "Churchill Livingstone",

}

RIS

TY - JOUR

T1 - Patterns of management and outcomes of unifocal versus multifocal glioblastoma

AU - Haque, Waqar

AU - Thong, Yvonne

AU - Verma, Vivek

AU - Rostomily, Robert

AU - Butler, E. Brian

AU - Teh, Bin S.

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Background: Glioblastoma (GBM) presents as a solitary lesion (unifocal), or as multiple discrete lesions (multifocal). Multifocal GBM may have a worse prognosis as compared to unifocal GBM, but existing data are limited to small institutional series. The purpose of the present study was to evaluate demographic and clinical characteristics of patients with unifocal versus multifocal GBM to highlight demographic differences and clinical outcomes for two groups of patients. Methods: The National Cancer Database (NCDB) was queried (2004–2016) for patients newly diagnosed with either unifocal or multifocal GBM. Statistics included Kaplan-Meier overall survival (OS) analysis, along with Cox proportional hazards modeling. Results: Of 45,268 total patients, 37,483 (82.8%) had unifocal GBM and 7,785 (17.2%) had multifocal GBM. Patients with unifocal GBM more frequently received gross total resection (GTR) (41.2% versus 25.8%, p < 0.001) and conventionally fractionated radiation therapy (RT) (48.2% versus 42.7%, p < 0.001). Patients with multifocal GBM had a higher rate of surgery with biopsy only (34.0% compared to 24.1%, p < 0.001). Median OS was 12.8 months versus 8.3 months (p < 0.001) for patients with unifocal GBM or multifocal GBM, respectively. On multivariate analysis, factors associated with improved OS included unifocal disease, MGMT methylation, RT use, and chemotherapy use. Conclusions: This is the largest study to date describing outcomes for patients with multifocal GBM, and it shows that multifocal GBM is associated with a decreased use both of GTR and conventionally fractionated RT, as well as worse median OS. Further research is needed to improve clinical outcomes for patients with multifocal GBM.

AB - Background: Glioblastoma (GBM) presents as a solitary lesion (unifocal), or as multiple discrete lesions (multifocal). Multifocal GBM may have a worse prognosis as compared to unifocal GBM, but existing data are limited to small institutional series. The purpose of the present study was to evaluate demographic and clinical characteristics of patients with unifocal versus multifocal GBM to highlight demographic differences and clinical outcomes for two groups of patients. Methods: The National Cancer Database (NCDB) was queried (2004–2016) for patients newly diagnosed with either unifocal or multifocal GBM. Statistics included Kaplan-Meier overall survival (OS) analysis, along with Cox proportional hazards modeling. Results: Of 45,268 total patients, 37,483 (82.8%) had unifocal GBM and 7,785 (17.2%) had multifocal GBM. Patients with unifocal GBM more frequently received gross total resection (GTR) (41.2% versus 25.8%, p < 0.001) and conventionally fractionated radiation therapy (RT) (48.2% versus 42.7%, p < 0.001). Patients with multifocal GBM had a higher rate of surgery with biopsy only (34.0% compared to 24.1%, p < 0.001). Median OS was 12.8 months versus 8.3 months (p < 0.001) for patients with unifocal GBM or multifocal GBM, respectively. On multivariate analysis, factors associated with improved OS included unifocal disease, MGMT methylation, RT use, and chemotherapy use. Conclusions: This is the largest study to date describing outcomes for patients with multifocal GBM, and it shows that multifocal GBM is associated with a decreased use both of GTR and conventionally fractionated RT, as well as worse median OS. Further research is needed to improve clinical outcomes for patients with multifocal GBM.

KW - Glioblastoma

KW - Multifocal GBM

KW - Radiation therapy

KW - Unifocal GBM

UR - http://www.scopus.com/inward/record.url?scp=85079891878&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85079891878&partnerID=8YFLogxK

U2 - 10.1016/j.jocn.2020.01.086

DO - 10.1016/j.jocn.2020.01.086

M3 - Article

VL - 74

SP - 155

EP - 159

JO - Journal of Clinical Neuroscience

T2 - Journal of Clinical Neuroscience

JF - Journal of Clinical Neuroscience

SN - 0967-5868

ER -

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