Prognosis
The median survival time from the time of diagnosis without any treatment is 3 months, but with treatment survival of 1–2 years is common. Increasing age (> 60 years of age) carries a worse prognostic risk. Death is usually due to cerebral edema or increased intracranial pressure.
A good initial Karnofsky Performance Score (KPS), and MGMT methylation are associated with longer survival. A DNA test can be conducted on glioblastomas to determine whether or not the promoter of the MGMT gene is methylated. Patients with a methylated MGMT promoter have been associated with significantly greater long-term benefit than patients with an unmethylated MGMT promoter. This DNA characteristic is intrinsic to the patient and currently cannot be altered externally.
Long-term benefits have also been associated with those patients who receive surgery, radiotherapy, and temozolomide chemotherapy. However, much remains unknown about why some patients survive longer with glioblastoma. Age of under 50 is linked to longer survival in glioblastoma multiforme, as is 98%+ resection and use of temozolomide chemotherapy and better Karnofsky performance scores. A recent study confirms how younger age is associated with a much better prognosis, with a small fraction of patients under 40 years of age achieving a population-based cure. The population-based cure is thought to occur when a population's risk of death returns to that of the normal population, and in GBM, this is thought to occur after 10 years.
UCLA Neuro-Oncology publishes real-time survival data for patients with this diagnosis. They are the only institution in the United States that shows how their patients are performing. They also show a listing of chemotherapy agents used to treat GBM tumors.
According to a 2003 study, glioblastoma multiforme prognosis can be divided into three subgroups dependent on KPS, the age of the patient, and treatment.
| RPA class | Definition | Historical Median Survival Time | Historical 1-Year Survival | Historical 3-Year Survival | Historical 5-Year Survival |
|---|---|---|---|---|---|
| III | Age < 50, KPS ≥ 90 | 17.1 months | 70% | 20% | 14% |
| IV | Age < 50, KPS < 90 | 11.2 months | 46% | 7% | 4% |
| Age > 50, KPS ≥ 70, surgical removal with good neurologic function | |||||
| V + VI | Age ≥ 50, KPS ≥ 70, surgical removal with poor neurologic function | 7.5 months | 28% | 1% | 0% |
| Age ≥ 50, KPS ≥ 70, no surgical removal | |||||
| Age ≥ 50, KPS < 70 |
Read more about this topic: Glioblastoma Multiforme