Prognostic Factors and Survival Prediction of Pediatric Glioblastomas: A Population-Based Study.

Abstract

To identify the risk factors for pediatric glioblastomas (GBMs), and to develop an effective prediction model to estimate the survival rate for these patients. Pediatric patients with GBM were extracted from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier analyses were performed for overall survival. Significant prognostic factors were identified using univariate and multivariate Cox regression analyses. A nomogram model was also established. A total of 378 pediatric patients with GBM were included in our study. The multivariate Cox analysis revealed that age at diagnosis (HR, 1.67; 95% CI, 1.19-2.35; p=0.003), tumor site (infratentorial vs. supratentorial: HR, 1.44; 95% CI, 1.03-2.03; p=0.035), surgery (gross total resection [GTR] vs. no surgery: HR, 0.53; 95% CI, 0.36-0.77, p < 0.001), and chemotherapy (HR, 0.56; 95% CI, 0.42-0.74; p < 0.001) were independent prognostic factors of overall survival for pediatric GBMs. Additionally, we found that patients with tumors located in the infratentorial region (p < 0.001) tended to receive conservative treatments. Moreover, our nomogram model showed favorable discriminative ability. At the population level, we found that older children and tumors located in the infratentorial region were associated with poor survival, while both GTR and chemotherapy were associated with improved survival. There was no association between radiotherapy and survival outcomes. Moreover, a nomogram with good performance was constructed to predict the overall survival of these patients.