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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Development and external validation of a clinical prediction model for survival in patients with IDH wild-type glioblastoma

Die Entwicklung und externe Validierung eines klinischen Prädiktionsmodells für die Überlebenszeiten von Patienten mit IDH wild-type Glioblastomen

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  • presenting/speaker Hendrik-Jan Mijderwijk - Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Daan Nieboer - Erasmus MC, Department of Public Health, Rotterdam, Deutschland
  • Fatih Incekara - Erasmus MC, Department of Neurosurgery, Brain Tumor Center, Rotterdam, Deutschland
  • Kerstin Berger - Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Ewout Steyerberg - Erasmus MC, Department of Public Health, Rotterdam, Deutschland; Leiden University Medical Center, Department of Biomedical Data Sciences, Leiden, Niederlande
  • Martin J. van den Bent - Erasmus MC, Department of Neurology, Brain Tumor Center, Rotterdam, Deutschland
  • Guido Reifenberger - Universitätsklinikum Düsseldorf, Department of Neuropathology, Düsseldorf, Deutschland
  • Daniel Hänggi - Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Marion Smits - Erasmus MC, Radiology and Nuclear Medicine, Rotterdam, Deutschland
  • Christian A. Senft - Universitätsklinikum Jena, Klinik und Poliklinik für Neurochirurgie, Jena, Deutschland
  • Marion Rapp - Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Michael Sabel - Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Martin Voss - Universitätsklinikum Frankfurt, Dr. Senckenberg Institute of Neurooncology, Frankfurt a. M., Deutschland
  • Marie-Thérèse Forster - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt a. M., Deutschland
  • Marcel A. Kamp - Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland; Universitätsklinikum Jena, Klinik und Poliklinik für Neurochirurgie, Jena, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV220

doi: 10.3205/22dgnc213, urn:nbn:de:0183-22dgnc2139

Published: May 25, 2022

© 2022 Mijderwijk 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

Text

Objective: Prognostication of glioblastoma survival has become more refined due to the molecular reclassification of these tumors into isocitrate dehydrogenase (IDH) wild-type and IDH mutant. Since this molecular stratification, however, robust clinical prediction models relevant to the entire IDH wild-type glioblastoma patient population are lacking. This study aimed to provide an updated model that predicts individual survival prognosis in patients with IDH wild-type glioblastoma.

Methods: Databases from Germany and the Netherlands provided data on 1036 newly diagnosed glioblastoma patients treated between 2012 and 2018. A clinical prediction model for all-cause mortality was developed with Cox proportional hazards regression. This model included recent glioblastoma-associated molecular markers in addition to well-known classic prognostic variables, which were updated and refined with additional categories. Model performance was evaluated according to calibration (using calibration plots and calibration slope) and discrimination (using a c-statistic) in a cross-validation procedure by country to assess external validity.

Results: The German and Dutch patient cohorts consisted of 710 and 326 patients, respectively, of whom 511 (72%) and 308 (95%) had died. Three models were developed, each with increasing complexity. The final model considering age, sex, preoperative Karnofsky Performance Status, extent of resection, O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status, and adjuvant therapeutic regimen showed an optimism-corrected c-statistic of 0.73 (95% confidence interval 0.71–0.75). Cross-validation between the national cohorts yielded comparable results (Figure 1 [Fig. 1]).

Conclusion: This prediction model reliably predicts individual survival prognosis in patients with newly diagnosed IDH wild-type glioblastoma, although additional validation, especially for long-term survival, may be desired. The nomogram and web application of this model may support shared decision-making if used properly (Figure 2 [Fig. 2]).

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The paper related to this abstract has been accepted for publication in the Journal of Neurosurgery.