Geographic Variations in the Incidence of Glioblastoma and Prognostic Factors Predictive of Overall Survival in US Adults from 2004–2013

Abstract

Objective: The purpose of this study was to evaluate variations in the regional incidence of glioblastoma in US adults in 2004–2013.Study Design and Setting: We evaluated 24,262 patients with primary glioblastoma. Data were categorized based on geographic regions that included different SEER registry sites as follows: (1) Northeast: Connecticut, New Jersey (3,977 patients); (2) South: Kentucky, Louisiana, Metropolitan Atlanta, Rural Georgia, Greater Georgia (excluding AT and RG) (5,212 patients); (3) North Central: Metropolitan Detroit, Iowa (2,320 patients); (4) West: Hawaii, New Mexico, Seattle (Puget Sound), Utah, San Francisco-Oakland SMSA, San Jose-Monterey, Los Angeles, Greater California (excluding SF, LA, and SJ), Alaska (12,753 patients).Results: Statistically significant differences in the rates of overall patient survival (P < 0.001) and the incidence of glioblastoma (24.31, 22.6, 20.35, 15.03 per 100,000/year in the South, Northeast, West, North Central regions, respectively) were identified between geographic regions. Multivariate Cox regression analysis demonstrated that overall survival was better in patients of Asian or Pacific Islander race. In addition, age, registry site, marital status, tumor laterality, histological classification, the extent of disease, tumor size, tumor extension, and treatment methods were identified as significant prognostic factors.Conclusion: Glioblastoma incidence is geographic region and race/ethnicity–dependent.

Genetic and expression variations of cell cycle pathway genes in brain tumor patients

“…Both cohorts of brain cancer contained higher number of glioma patients compared with other type of brain tumors such as meningioma and pituitary adenomas. Previous studies have also reported the increased incidence of glioma (77-81% of all primary malignant tumors of CNS) in the southeast, northwest, and midwest of U.S.A. [22], Asian population and Hispanic population [23] compared with meningioma and pituitary adenomas. Reasons binding these incidence differences can be variations in geographic regions, environmental factors, diet, occupational and personal exposures and lifestyle [22,24].…”

“…Previous studies have also reported the increased incidence of glioma (77-81% of all primary malignant tumors of CNS) in the southeast, northwest, and midwest of U.S.A. [22], Asian population and Hispanic population [23] compared with meningioma and pituitary adenomas. Reasons binding these incidence differences can be variations in geographic regions, environmental factors, diet, occupational and personal exposures and lifestyle [22,24]. In addition, ethnic/race variations are likely to contribute to observed differences [25,26].…”

Race influences survival in glioblastoma patients with KPS ≥ 80 and associates with genetic markers of retinoic acid metabolism

“…evaluated 24,262 patients with primary glioblastoma using SEER data, and did not find statistically significance on overall survival between African-American and White patients, but they did not include KPS in their COX regression model, which was recognized as an important factor associated with survival, thus led to a biased result despite the large sample size. [17] Haley Gittleman etc. built a nomogram to estimate individualized survival probabilities for patients with newly diagnosed GBM, using data from two independent NRG Oncology Radiation Therapy Oncology Group (RTOG) clinical trials.…”

Ultrasound Activated Nano TiO2 Loaded With Temozolomide Paves the Way for Resection of Chemo-resistant Glioblastoma Multiforme

“…Glioblastoma is a major type of glioma that primarily affects the central nervous system and known with highly engraved prognosis and postdiagnosis patient survival for less than 15 months (Xu, Chen et al 2017, Patel, Fisher et al 2019. Temozolomide (TMZ) is the only Food and Drug Administration (FDA) approved therapeutic agent for GBM that could merely add several months to the survival of patients and is mostly used as adjuvant therapy after surgical resection of the tumor (Chamberlain 2010).…”