Aims: Glioblastoma (GBM) is the most common and aggressive primary malignant brain tumour in adults, with a poor prognosis. Changing treatment paradigms suggest improved outcome, but whole nation data for England is scarce. The aim of this report is to examine the incidence of patients with glioblastoma in England, and to assess the influence of gender, age, geographical region and treatment on outcome.
Methods: A search strategy encompassing all patients coded with GBM and treated from January 2007 to December 2011 was obtained from data linkage between the National Cancer Registration Service and Hospital Episode Statistics for England.
Results: There were 10,743 patients coded with GBM in this 5-year period (6451 male, 4292 female), giving an overall national age standardised incidence of 4.64/100,000/year. Incidence increases with age. Median survival overall was 6.1 months. One, 2 and 5-year survivals, were 28.4%, 11.5% and 3.4% respectively. Age stratified median survivals decreased significantly (p<0.0001) with increasing age from 16.2 months for the 20-44 year age group, to 7.9 months for the 45-69 years, and 3.2 months for 70+years. In the maximal treatment subgroup, patients aged up to 69 years had a median survival of 14.9 months. Patients over 60 years were less likely to receive maximal combination treatment but median survival was better with maximal treatment at all ages.
Conclusions: The overall outcome for patients with GBM remains poor. However, aggressive treatment at every age group is associated with extended survival similar to that described in clinical trials.
Keywords: Cancer; Elderly; Glioblastoma; High grade glioma; Incidence; Outcome; Paediatric; Population studies; Temozolomide; Treatment.
Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.