BJC reports · 2025
Medical comorbidities prognosticate survival in glioblastoma.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Bessette Justin, Arditi Jonathan, Noreck Julia, Edwards Robert, Kaiserman Jacob, Wortelboer Rainy, Nguyen Mary Ann, Siwik William, Gautam Shiva, Szymanski Tara, Wong Eric T
Аннотация
BACKGROUND: Medical comorbidities are prevalent in the glioblastoma population, although their effects on survival are not well established.
METHODS: We retrospectively extracted known prognostic factors and medical comorbidities at the time of glioblastoma diagnosis for 867 patients who presented to Rhode Island Hospital from 2005-2022.
RESULTS: All established prognostic factors were represented. Median age was 65 years (range <1-93). A higher number of comorbidities was associated with older age (p < 0.0001). Having >5 comorbidities doubled the hazard ratio compared to ≤1. While comorbidity burden correlated with decreased survival, the Charlson Comorbidity Index mainly captured the effect of age (Spearman r2 = 0.874) while secondarily accounting for comorbidities. In univariate analysis, hypertension, hyperlipidemia, type 2 diabetes mellitus, atrial fibrillation, stroke, chronic obstructive pulmonary disease, and other malignancies negatively influenced survival. Multivariate analysis demonstrated that tumor resection, temozolomide/radiotherapy, O6-methylguanine-DNA methyltransferase methylation, and bevacizumab use were protective. Pairwise analysis identified that obesity and atrial fibrillation had a higher hazard ratio of 3.3 compared to those with either or none.
CONCLUSIONS: Findings from this cohort indicate that systemic metabolism plays an important role in modulating survival, and combinatorial comorbidity analysis reveals that untreated obstructive sleep apnea is a potential risk factor for worsened outcomes.
METHODS: We retrospectively extracted known prognostic factors and medical comorbidities at the time of glioblastoma diagnosis for 867 patients who presented to Rhode Island Hospital from 2005-2022.
RESULTS: All established prognostic factors were represented. Median age was 65 years (range <1-93). A higher number of comorbidities was associated with older age (p < 0.0001). Having >5 comorbidities doubled the hazard ratio compared to ≤1. While comorbidity burden correlated with decreased survival, the Charlson Comorbidity Index mainly captured the effect of age (Spearman r2 = 0.874) while secondarily accounting for comorbidities. In univariate analysis, hypertension, hyperlipidemia, type 2 diabetes mellitus, atrial fibrillation, stroke, chronic obstructive pulmonary disease, and other malignancies negatively influenced survival. Multivariate analysis demonstrated that tumor resection, temozolomide/radiotherapy, O6-methylguanine-DNA methyltransferase methylation, and bevacizumab use were protective. Pairwise analysis identified that obesity and atrial fibrillation had a higher hazard ratio of 3.3 compared to those with either or none.
CONCLUSIONS: Findings from this cohort indicate that systemic metabolism plays an important role in modulating survival, and combinatorial comorbidity analysis reveals that untreated obstructive sleep apnea is a potential risk factor for worsened outcomes.