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- Title
Prognostic impact of obesity in newly-diagnosed glioblastoma: a secondary analysis of CeTeG/NOA-09 and GLARIUS.
- Authors
Weller, Johannes; Schäfer, Niklas; Schaub, Christina; Potthoff, Anna-Laura; Steinbach, Joachim P.; Schlegel, Uwe; Sabel, Michael; Hau, Peter; Seidel, Clemens; Krex, Dietmar; Goldbrunner, Roland; Pietsch, Torsten; Tzaridis, Theophilos; Zeyen, Thomas; Borger, Valeri; Güresir, Erdem; Vatter, Hartmut; Herrlinger, Ulrich; Schneider, Matthias
- Abstract
Purpose: The role of obesity in glioblastoma remains unclear, as previous analyses have reported contradicting results. Here, we evaluate the prognostic impact of obesity in two trial populations; CeTeG/NOA-09 (n = 129) for MGMT methylated glioblastoma patients comparing temozolomide (TMZ) to lomustine/TMZ, and GLARIUS (n = 170) for MGMT unmethylated glioblastoma patients comparing TMZ to bevacizumab/irinotecan, both in addition to surgery and radiotherapy. Methods: The impact of obesity (BMI ≥ 30 kg/m2) on overall survival (OS) and progression-free survival (PFS) was investigated with Kaplan–Meier analysis and log-rank tests. A multivariable Cox regression analysis was performed including known prognostic factors as covariables. Results: Overall, 22.6% of patients (67 of 297) were obese. Obesity was associated with shorter survival in patients with MGMT methylated glioblastoma (median OS 22.9 (95% CI 17.7–30.8) vs. 43.2 (32.5–54.4) months for obese and non-obese patients respectively, p = 0.001), but not in MGMT unmethylated glioblastoma (median OS 17.1 (15.8–18.9) vs 17.6 (14.7–20.8) months, p = 0.26). The prognostic impact of obesity in MGMT methylated glioblastoma was confirmed in a multivariable Cox regression (adjusted odds ratio: 2.57 (95% CI 1.53–4.31), p < 0.001) adjusted for age, sex, extent of resection, baseline steroids, Karnofsky performance score, and treatment arm. Conclusion: Obesity was associated with shorter survival in MGMT methylated, but not in MGMT unmethylated glioblastoma patients.
- Subjects
GLIOBLASTOMA multiforme; SECONDARY analysis; O6-Methylguanine-DNA Methyltransferase; PROGNOSIS; OBESITY; RADIOTHERAPY
- Publication
Journal of Neuro-Oncology, 2022, Vol 159, Issue 1, p95
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-022-04046-z