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Neurooncol Pract. 2019 Dec;6(6):451-462. doi: 10.1093/nop/npz019. Epub 2019 May 18.

Sex is an important prognostic factor for glioblastoma but not for nonglioblastoma.

Author information

1
Central Brain Tumor Registry of the United States, Hinsdale, IL.
2
Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH.
3
Department of Population Health and Quantitative Sciences, Case Western Reserve University School of Medicine, Cleveland, OH.
4
Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX.
5
Department of Neurological Surgery, University Hospitals of Cleveland and Case Western University School of Medicine, OH.
6
Seidman Cancer Center, University Hospitals of Cleveland, OH.
7
Washington University School of Medicine, St. Louis, MO.
8
Translational Genomics Research Institute, Phoenix, AZ.
9
Cleveland Clinic, Lerner Research Institute, OH.
10
Department of Neurosurgery, Penn State Cancer Institute, Penn State, State College.

Abstract

Background:

Glioblastoma (GBM) is the most common and most malignant glioma. Nonglioblastoma (non-GBM) gliomas (WHO Grades II and III) are invasive and also often fatal. The goal of this study is to determine whether sex differences exist in glioma survival.

Methods:

Data were obtained from the National Cancer Database (NCDB) for years 2010 to 2014. GBM (WHO Grade IV; N = 2073) and non-GBM (WHO Grades II and III; N = 2963) were defined using the histology grouping of the Central Brain Tumor Registry of the United States. Non-GBM was divided into oligodendrogliomas/mixed gliomas and astrocytomas. Sex differences in survival were analyzed using Kaplan-Meier and multivariable Cox proportional hazards models adjusted for known prognostic variables.

Results:

There was a female survival advantage in patients with GBM both in the unadjusted (P = .048) and adjusted (P = .003) models. Unadjusted, median survival was 20.1 months (95% CI: 18.7-21.3 months) for women and 17.8 months (95% CI: 16.9-18.7 months) for men. Adjusted, median survival was 20.4 months (95% CI: 18.9-21.6 months) for women and 17.5 months (95% CI: 16.7-18.3 months) for men. When stratifying by age group (18-55 vs 56+ years at diagnosis), this female survival advantage appeared only in the older group, adjusting for covariates (P = .017). Women (44.1%) had a higher proportion of methylated MGMT (O6-methylguanine-DNA methyltransferase) than men (38.4%). No sex differences were found for non-GBM.

Conclusions:

Using the NCDB data, there was a statistically significant female survival advantage in GBM, but not in non-GBM.

KEYWORDS:

NCDB; glioblastoma; glioma; sex differences; survival

PMID:
31832215
PMCID:
PMC6899055
[Available on 2020-12-07]
DOI:
10.1093/nop/npz019

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