Glioblastoma in the real-world setting: patterns of care and outcome in the Austrian population

Andreas Hainfellner, Martin Borkovec, Lukas Seebrecht, Magdalena Neuhauser, Thomas Roetzer-Pejrimovsky, Lisa Greutter, Birgit Surboeck, Andrea Hager-Seifert, Doris Gorka-vom Hof, Tadeja Urbanic-Purkart, Martin Stultschnig, Clemens Cijan, Franz Wuertz, Bernadette Calabek-Wohinz, Josef Pichler, Isolde Hoellmueller, Annette Leibetseder, Serge Weis, Waltraud Kleindienst (Co-author), Michael Seiberl (Co-author)Lara Bieler (Co-author), Constantin Hecker (Co-author), Christoph Schwartz (Co-author), Sarah Iglseder, Johanna Heugenhauser, Martha Nowosielski, Claudius Thome, Patrizia Moser, Markus Hoffermann, Karin Loibnegger, Karin Dieckmann, Matthias Tomschik, Georg Widhalm, Karl Roessler, Christine Marosi, Adelheid Woehrer, Johannes A. Hainfellner, Stefan Oberndorfer

Research output: Contribution to journalOriginal Article (Journal)peer-review

Abstract

Purpose We present results of a retrospective population-based investigation of patterns of care and outcome of glioblastoma patients in Austria. Patients and methods In this nation-wide cooperative project, all Austrian glioblastoma patients newly diagnosed between 2014 and 2018 and registered in the ABTR-SANOnet database were included. Histological typing used criteria of the WHO classification of CNS tumors, 4th edition 2016. Patterns of care were assessed, and all patients were followed until the end of 2019. Results 1,420 adult glioblastoma cases were identified. 813 (57.3%) patients were male and 607 (42.7%) female. Median age at diagnosis was 64 years (range: 18-88). Median overall survival (OS) was 11.6 months in the total cohort and 10.9 months in patients with proven IDH-wildtype. Median OS in the patient group <= 65 years receiving postoperative standard of care therapy was 16.1 months. In the patient group > 65 years with postoperative therapy, median OS was 11.2 months. Follow-up >= 5 years identified 13/264 (4.9%) long-term survivors. Brain tumor surgery frequently was assisted by 5-aminolevulinic acid (5-ALA) fluorescence (up to 55%). Postoperative treatment was initiated around one month after surgery (median: 31 days) following standardized protocols in 1,041/1,420 (73.3%) cases. In 830 patients (58.5%), concomitant radiochemotherapy was started according to the established standard of care. Treatment in case of progressive disease was considerably variable. 170/1,420 patients (12.0%) underwent a second surgical procedure, 467 (33.0%) received systemic treatment after progression, and 173 (12.2%) were re-irradiated. Conclusion Our data illustrate and confirm nation-wide translation of effective standard of care to Austrian glioblastoma patients in the recent past. In the case of progressive disease, highly variable therapeutic approaches were used, most frequently accompanied by anti-angiogenic therapy. Long-term survival was observed in a minor proportion of mostly younger patients who typically had gross total tumor resection, a favorable postoperative ECOG score, and standard of care therapy.
Original languageEnglish
Number of pages12
JournalJOURNAL OF NEURO-ONCOLOGY
Early online dateAug 2024
DOIs
Publication statusPublished - 27 Aug 2024

Keywords

  • Glioblastoma
  • Outcome
  • Prognosis
  • Registry

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