Patterns of care and survival for glioblastoma patients in the Veterans population

被引:20
作者
Arrigo, Robert T. [2 ,3 ]
Boakye, Maxwell [1 ,3 ]
Skirboll, Stephen L. [3 ,4 ,5 ]
机构
[1] Univ Louisville, Ctr Adv Neurosurg, Louisville, KY 40202 USA
[2] Stanford Univ, Sch Med, Stanford, CA 94305 USA
[3] VA Palo Alto Hlth Care Syst, Outcomes Res Lab, Palo Alto, CA 94304 USA
[4] Stanford Univ, Med Ctr, Dept Neurosurg, Palo Alto, CA 94304 USA
[5] VA Palo Alto Hlth Care Syst, Neurosurg Sect, Palo Alto, CA 94304 USA
关键词
Veterans; Survival analysis; Brain cancer; Glioblastoma multiforme; SEER; Epidemiology; PROGNOSTIC-FACTORS; KNEE ARTHROPLASTY; MALIGNANT GLIOMA; RADIOTHERAPY; OUTCOMES; EPIDEMIOLOGY; MULTIFORME; MANAGEMENT; MEDICARE; QUALITY;
D O I
10.1007/s11060-011-0702-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Survival outcomes and patterns of care for brain tumor patients in the USA Veterans population have not been previously published and the extent of variation in outcomes between Veterans and the rest of the USA is currently unknown. The Veterans healthcare administration (VA) provides comprehensive care to Veterans and their families and maintains the Veterans affairs central cancer registry (VACCR). This was a retrospective review of microscopically-confirmed, supratentorial glioblastoma multiforme in male Veterans actively followed by the VACCR; survival was analyzed and compared to a national cohort from the surveillance, epidemiology and end results program. We analyzed 1,219 Veterans with glioblastomas diagnosed between 1997 and 2006. Median survival was 6.5 months and 1, 2, and 5 years survival rates were 26.8, 5.4, and 0.5%, respectively. Patients receiving all three treatment modalities (surgical resection, radiotherapy, and chemotherapy) did best; these findings remained true among patients aged 70 and older such that these patients had an overall survival similar to those age < 70. A comparable national cohort had longer median survival (9.0 months) and greater 1, 2, and 5 years survival rates (37.8, 12.8, and 4.1%) than the VA cohort. Survival and patterns of care are presented for the first time for Veterans with glioblastoma multiforme. In conclusion, we found that more aggressive therapy was associated with better survival, even among elderly Veterans and whether compared overall or by age group, VA patients showed decreased survival relative to a national cohort. We believe this potential disparity warrants further investigation.
引用
收藏
页码:627 / 635
页数:9
相关论文
共 34 条
[1]   Quality of pancreatic cancer care at Veterans Administration compared with non-Veterans Administration hospitals [J].
Bilimoria, Karl Y. ;
Bentrem, David J. ;
Tomlinson, James S. ;
Merkow, Ryan P. ;
Stewart, Andrew K. ;
Ko, Clifford Y. ;
Prystowsky, Jay B. ;
Talamonti, Mark S. .
AMERICAN JOURNAL OF SURGERY, 2007, 194 (05) :588-593
[2]   A prospective study on glioblastoma in the elderly [J].
Brandes, AA ;
Vastola, F ;
Basso, U ;
Berti, F ;
Pinna, G ;
Rotilio, A ;
Gardiman, M ;
Scienza, R ;
Monfardini, S ;
Ermani, M .
CANCER, 2003, 97 (03) :657-662
[3]   CHEMOTHERAPY FOR ANAPLASTIC OLIGODENDROGLIOMA [J].
CAIRNCROSS, G ;
MACDONALD, D ;
LUDWIN, S ;
LEE, D ;
CASCINO, T ;
BUCKNER, J ;
FULTON, D ;
DROPCHO, E ;
STEWART, D ;
SCHOLD, C ;
WAINMAN, N ;
EISENHAUER, E .
JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (10) :2013-2021
[4]   A population-based study of lung carcinoma in Pennsylvania - Comparison of Veterans Administration and civilian populations [J].
Campling, BG ;
Hwang, WT ;
Zhang, JM ;
Thompson, S ;
Litzky, LA ;
Vachani, A ;
Rosen, IM ;
Algazy, KM .
CANCER, 2005, 104 (04) :833-840
[5]  
*CBTRUS, 2007, PRIM BRAIN TUM US ST
[6]   A proposed classification system that projects outcomes based on preoperative variables for adult patients with glioblastoma multiforme Clinical article [J].
Chaichana, Kaisorn ;
Parker, Scott ;
Olivi, Alessandro ;
Quinones-Hinojosa, Alfredo .
JOURNAL OF NEUROSURGERY, 2010, 112 (05) :997-1004
[7]   Medical progress: Brain tumors [J].
DeAngelis, LM .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (02) :114-123
[8]  
El-Zein R, 2004, CONT CANC RES, P3
[9]   Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma [J].
Filippini, Graziella ;
Falcone, Chiara ;
Boiardi, Amerigo ;
Broggi, Giovanni ;
Bruzzone, Maria G. ;
Caldiroli, Dario ;
Farina, Rita ;
Farinotti, Mariangela ;
Fariselli, Laura ;
Finocchiaro, Gaetano ;
Giombini, Sergio ;
Polio, Bianca ;
Savoiardo, Mario ;
Solero, Carlo L. ;
Valsecchi, Maria G. .
NEURO-ONCOLOGY, 2008, 10 (01) :79-87
[10]   STUDYING OUTCOMES AND HOSPITAL UTILIZATION IN THE ELDERLY - THE ADVANTAGES OF A MERGED DATA-BASE FOR MEDICARE AND VETERANS-AFFAIRS-HOSPITALS [J].
FLEMING, C ;
FISHER, ES ;
CHANG, CH ;
BUBOLZ, TA ;
MALENKA, DJ .
MEDICAL CARE, 1992, 30 (05) :377-391