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Predictors of mortality in patients with primary spinal cord glioblastoma

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Abstract

Purpose

Primary spinal cord glioblastoma (GBM) is a rare and devastating disease. Little attention was ever paid to this rare disease. As a result, the standard treatment protocol and prognostic factors of primary spinal cord GBM were not well established. The aim of this study was to determine the predictors associated with survival in patients with primary spinal cord GBM.

Methods

A total of 122 patients with primary spinal cord GBM from Surveillance, Epidemiology, and End Results database and our institution were included in this retrospective analysis. Information about age, sex, race, tumor invasion, extent of resection, radiation, chemotherapy and year of diagnosis was collected. Univariate and multivariate accelerated failure time (AFT) regression model was performed to identify prognostic factors.

Results

Of the 122 patients, 102 (83.6%) expired at the time of data collection. Overall survival at 1 year, 2 years, 3 years and 5 years was 48.4%, 22.8%, 17.1% and 8.4%, respectively, and median survival time was 12 months. Only radiation was found to be associated with survival in the AFT regression model (time ratio 1.94, 95% CI 1.01–3.72, p < 0.05). Radiotherapy could improve survival slightly; patients who received RT survived approximately two times as long as patients who did not receive RT, but the advantage was short term.

Conclusion

The survival of primary spinal cord GBM is poor in the current treatment strategy. Radiotherapy was associated with better survival, but the advantage was short term.

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Abbreviations

AIC:

Akaike’s information criterion

AFT:

Accelerated failure time model

CSF:

Cerebrospinal fluid

IQR:

Interquartile range

GBM:

Glioblastoma

GTR:

Gross total resection

PH:

Proportional hazards assumption

RT:

Radiotherapy

S/PR:

Subtotal/partial resection

TMZ:

Temozolomide

95% CI:

95% Confidence interval

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Authors and Affiliations

  1. Department of Neurosurgery, Xuanwu Hospital, China International Neuroscience Institute, Capital Medical University, 45 Changchun Street, Western District, Beijing, 100053, China

    Lei Cheng, Qingyu Yao, Longbing Ma, Wanru Duan, Jian Guan, Can Zhang, Kai Wang, Zhenlei Liu, Fengzeng Jian, Hao Wu, Zan Chen, Xingwen Wang & Zuowei Wang

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  1. Lei Cheng
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  2. Qingyu Yao
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  3. Longbing Ma
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  4. Wanru Duan
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  5. Jian Guan
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  7. Kai Wang
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  11. Zan Chen
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Correspondence to Fengzeng Jian.

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The study was approved by the ethical board of Xuanwu Hospital.

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Cheng, L., Yao, Q., Ma, L. et al. Predictors of mortality in patients with primary spinal cord glioblastoma. Eur Spine J 29, 3203–3213 (2020). https://doi.org/10.1007/s00586-020-06515-3

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