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Comparison of Survival Between Cerebellar and Supratentorial Glioblastoma Patients: Surveillance, Epidemiology, and End Results (SEER) Analysis

Jeswani, Sunil MD*; Nuño, Miriam PhD*; Folkerts, Vanessa BA; Mukherjee, Debraj MD, MPH; Black, Keith L. MD; Patil, Chirag G. MD, MS

doi: 10.1227/01.neu.0000430288.85680.37
Research-Human-Clinical Studies

BACKGROUND: Cerebellar glioblastoma multiforme (cGBM) is rare, and although there is a general belief that these tumors have a worse prognosis than supratentorial GBM (sGBM), few studies have been published to support this belief.

OBJECTIVE: To investigate the effect of cerebellar location on survival through a case-control design comparing overall survival time of cGBM and sGBM patients.

METHODS: The Surveillance, Epidemiology, and End Results (SEER) registry was used to identify 132 patients with cGBM (1973-2008). Each cGBM patient was matched with an sGBM patient from among 20 848 sGBM patients on the basis of age, extent of resection, decade of diagnosis, and radiation therapy using propensity score matching.

RESULTS: Within the cGBM, 37% were older than 65 years of age, 62% were men, and 87% were white. Most patients underwent surgery and radiation (74%), whereas only 26% underwent surgical resection only. The median survival time for the cGBM and sGBM matched cohort was 8 months; however, the survival distributions differed (log-rank P = .04). Survival time for cGBM vs sGBM at 2 years was 21.5% vs 8.0%, and 12.7% vs 5.3% at 3 years. Multivariate analysis of survival among cGBM patients showed that younger age (P < .0001) and having radiation therapy (P < .0001) were significantly associated with reduced hazard of mortality. Among all patients, multivariate analysis showed that tumor location (P = .03), age (P < .0001), tumor size (P = .009), radiation (P < .0001), and resection (P < .0001) were associated with survival time in the unmatched cohort.

CONCLUSION: Median survival time for cGBM and sGBM patients was 8 months, but cGBM patients had a survival time advantage as the study progressed. These findings suggest that cGBM patients should be treated as aggressively as sGBM patients with surgical resection and radiation therapy.

ABBREVIATIONS: GBM, glioblastoma multiforme

cGBM, cerebellar glioblastoma multiforme

IQR, interquartile range

SEER, Surveillance, Epidemiology, and End Results

sGBM, supratentorial glioblastoma multiforme

Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California

Correspondence: Chirag G. Patil, MD, MS, Center for Neurosurgical Outcomes Research, Department of Neurosurgery, Cedars-Sinai Medical Center, 8631 W. Third Street, Suite 800E, Los Angeles, CA 90048. E-mail: chirag.patil@cshs.org

* Authors contributed equally to the manuscript.

Received October 30, 2012

Accepted March 20, 2013

Copyright © by the Congress of Neurological Surgeons