gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Comparison of the effect of different treatment strategies within discrepant healthcare systems on survival of glioblastoma patients

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  • Pantelis Stavrinou - Neurochirurgische Abteilung, Uniklinik Köln, Uniklinik Köln, Köln, Deutschland
  • Sotiris Katsigiannis - Köln, Deutschland
  • Christina A. Hamisch - Klinik und Poliklinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • George Stranjalis - Neurosurgical Department, University Hospital Evangelismos, Athens, Greece
  • Boris Krischek - Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland
  • Roland Goldbrunner - Klinikum der Universität zu Köln, Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.14.05

doi: 10.3205/17dgnc082, urn:nbn:de:0183-17dgnc0827

Published: June 9, 2017

© 2017 Stavrinou et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Whether an interdisciplinary treatment approach within a well-financed, robust healthcare system plays a significant role on the survival of glioblastoma patients remains unclear. The goal of this study was to examine survival in parallel cohorts of glioblastoma patients from two university hospitals with different treatment strategies functioning within two completely different healthcare systems.

Methods: We retrospectively analyzed two matched cohorts from a university hospital in Greece (188 patients) and Germany (189 patients). In both centers patients were treated with surgery followed by radiochemotherapy according to the stupp protocol. In case of recurrence, Greek patients were treated rather conservatively and the further therapeutic decisions were made by the primary treating physisian were as German patients were treated more aggressively, with a strategy that was developed within an inderdisciplinary tumorboard. The primary endpoint was progression-free and overall survival. Groups were compared using the Kaplan-Meier method for survival estimates.

Results: Both groups were comparable with respect to baseline parameters. Only 17% of Greek patients versus 88% of German patiens received second line treatment. Progression-free survival was similar for both patient cohorts (PFSGreece=9.9 months vs PFSGermany=9.0 months, p=0.37). Median survival was 12 months (95% CI, 9.4-14.5) and 16.6 months (95% CI, 13.3-19.8) for Greek and German patients respectively (p=0.02).

Conclusion: Treatment steared by a neurooncological tumorboard, functioning within a well financed-health care system and favoring second line treatment for recurrent glioblastomas was associated with significantly better overall survival.