OS13.7.A ONSET SYMPTOMS PREDICT SURVIVAL IN GLIOBLASTOMA PATIENTS -REAL WORLD DATA FROM 1719 PATIENTS IN THE SWEDISH BRAIN TUMOUR REGISTRY 2018-2021

Abstract

Abstract BACKGROUND Glioblastoma, the most common malignant brain tumour in adults, still has a poor long term survival. Non-invasive clinical prognostic markers are important to more accurately predict a patient’s survival. The aim of our register-based real-life study was to explore if onset symptoms have a prognostic value for survival. MATERIAL AND METHODS Data on onset symptoms and survival, as well as known prognostic factors, were retrieved for all glioblastoma patients registered in the Swedish Brain Tumour Registry between 2018 and 2021. The prognostic impact of different onset symptoms were calculated using the Cox proportional hazard model. RESULTS Data from 1719 adults with pathologically verified glioblastoma were analysed. The median survival was 347 days (330-364). The two-year survival was 21.9 %. The most common onset symptoms were focal neurological deficits, cognitive dysfunction, headache, epilepsy, and signs of raised intracranial pressure, with some patients having multiple symptoms. Patients with initial cognitive dysfunction had a significantly shorter survival compared to patients without cognitive dysfunction (p<0.001). Patients with onset seizures had significantly longer survival compared to patients with no onset seizures (p<0.001). The differences in survival remained after Cox regressions adjusting for known prognostic factors. When comparing tumors of the same size, there was still a difference in survival between patients having or not having cognitive dysfunction. CONCLUSION This large real-life study shows that initial cognitive impairment is a negative, and epileptic seizure at onset is a positive prognostic factor for survival in glioblastoma patients.