Comorbid Medical Conditions as Predictors of Overall Survival in Glioblastoma Patients

Abstract

Glioblastoma (GBM) is an aggressive central nervous system tumor with a poor prognosis. This study was conducted to determine any comorbid medical conditions that are associated with survival in GBM. Data were collected from medical records of all patients who presented to VCU Medical Center with GBM between January 2005 and February 2015. Patients who underwent surgery/biopsy were considered for inclusion. Cox proportional hazards regression modeling was performed to assess the relationship between survival and sex, race, and comorbid medical conditions. 163 patients met inclusion criteria. Comorbidities associated with survival on individual-characteristic analysis included: history of asthma (Hazard Ratio [HR]: 2.63; 95% Confidence Interval [CI]: 1.24–5.58; p = 0.01), hypercholesterolemia (HR: 1.95; 95% CI: 1.09–3.50; p = 0.02), and incontinence (HR: 2.29; 95% CI: 0.95–5.57; p = 0.07). History of asthma (HR: 2.22; 95% CI: 1.02–4.83; p = 0.04) and hypercholesterolemia (HR: 1.99; 95% CI: 1.11–3.56; p = 0.02) were associated with shorter survival on multivariable analysis. Surgical patients with GBM who had a prior history of asthma or hypercholesterolemia had significantly higher relative risk for mortality on individual-characteristic and multivariable analyses.

Clinical Risk and Overall Survival in Patients with Diabetes Mellitus, Hyperglycemia and Glioblastoma Multiforme. A Review of the Current Literature

“…Genetic mutations and molecular tumor markers became integral part of GBM assessment in modern neuro-oncology [ 22 ]. Nowadays, the well-known genetic mutations like O6-methylguanine methyltransferase (MGMT) promoter methylation, which is associated with a significantly higher median survival after therapy with TMZ [ 23 ] and other molecular tumor biomarkers, such as epidermal growth factor receptor (EGFR) amplification, aldehyde dehydrogenase 1A3 (ALDH1A3) and isocitrate dehydrogenase (IDH1/IDH2) isoforms are currently foci of research and were also linked to prognosis [ 22 , 24 ]. Limited data exist on the prevalence of DM2 among patients with GBM.…”

Frontiers in Anti-Cancer Drug Discovery: Challenges and Perspectives of Metformin as Anti-Angiogenic Add-On Therapy in Glioblastoma

“…A study conducted by Chaichana et al on 182 patients with low-grade gliomas (WHO grade (ii)) reported that constant hyperglycemia resulted in a decrease of treatment efficacy, with consequent decrease of patient survival and increased tumor recurrence [ 85 ]. Analogous results were obtained examining patients with high-grade gliomas and glioblastoma, so that patients with glioblastoma and diabetes showed a worse prognosis [ 86 , 87 , 88 ]. These observations suggested the potential beneficial effects of drugs lowering blood glucose concentration in the treatment of glioma.…”

Predictors of survival in elderly patients undergoing surgery for glioblastoma

“…Previous research examining individual medical comorbidities in GBM patients of all ages found that specific comorbidities asthma and hypercholesterolemia were related to decreased survival, however, these comorbidities were present in less than 10% of their study population, and further research confirming these findings is needed. 17 A recent review of the literature found that the presence of hyperglycemia, rather than diabetes, was an independent risk factor for poor outcome and shorter OS in patients with GBM. 18 Liu et al found that lower systolic blood pressure, lower albumin, and higher blood glucose were associated with worse survival.…”