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Purpose <p>Glioblastoma (GBM) is a highly aggressive brain tumor with poor outcomes, most commonly affecting older adults. Young adults (YA; ages 18–39), though less frequently affected, demonstrate distinct clinical and biological characteristics that may influence treatment response and survival. This study aimed to evaluate treatment patterns and outcomes in YA GBM relative to older adults in a national dataset.</p> Methods <p>This retrospective cohort analysis of the National Cancer Database (NCDB) from 2004 to 2021 identified GBM patients aged 18 years and older. Baseline demographics, tumor characteristics, and treatment patterns were compared between YAs and patients aged ≥ 40 years. Survival analysis was limited to isocitrate dehydrogenase (IDH)-wildtype GBM diagnosed in 2018 or later. Multivariable Cox regression was used to identify factors associated with overall survival (OS).</p> Results <p>Of 179,854 GBM patients, 6,941 (4.2%) were YAs. Compared with older adults, YAs were more likely to be non-White (19.9% vs. 10.8%), uninsured (5.9% vs. 2.2%), and treated at academic centers (75.9% vs. 68.0%). YAs more frequently underwent gross total resection (30.0% vs. 25.1%) and received the Stupp regimen (58.8% vs. 46.0%). Median OS time was significantly longer in YAs (25.8 vs. 11.4 months, <i>p</i> &lt; 0.001), with 5-year survival probabilities of 30.6% for YAs vs. 5.0% for older adults. Multivariable analysis confirmed that YA status was independently associated with improved OS (hazard ratio = 0.43, <i>p</i> &lt; 0.001).</p> Conclusion <p>YA GBM patients experience better survival and receive more aggressive treatment than older adults. These findings support the need for age-adapted therapeutic strategies and highlight the importance of integrating molecular profiling and survivorship planning in YA GBM care.</p>

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Glioblastoma in young adult patients: contemporary patterns of care and survival in the United States

  • 期刊论文

  • 发表日期：

    2025年7月15日

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  • Ory Haisraely,
  • Srivatsa Vedala,
  • Areeba Al-Sharfeen,
  • Gohar S. Manzar,
  • Subha Perni,
  • Martin C. Tom,
  • Thomas H. Beckham,
  • Chenyang Wang,
  • Debra N. Yeboa,
  • Caroline Chung,
  • Mary Frances McAleer,
  • Amol J. Ghia,
  • Chibawanye I. Ene,
  • Shiao-Pei Weathers,
  • Susan L. McGovern,
  • Christine F. Wogan,
  • Michael Roth,
  • Jing Li,
  • Brian De

摘要

Purpose

Glioblastoma (GBM) is a highly aggressive brain tumor with poor outcomes, most commonly affecting older adults. Young adults (YA; ages 18–39), though less frequently affected, demonstrate distinct clinical and biological characteristics that may influence treatment response and survival. This study aimed to evaluate treatment patterns and outcomes in YA GBM relative to older adults in a national dataset.

Methods

This retrospective cohort analysis of the National Cancer Database (NCDB) from 2004 to 2021 identified GBM patients aged 18 years and older. Baseline demographics, tumor characteristics, and treatment patterns were compared between YAs and patients aged ≥ 40 years. Survival analysis was limited to isocitrate dehydrogenase (IDH)-wildtype GBM diagnosed in 2018 or later. Multivariable Cox regression was used to identify factors associated with overall survival (OS).

Results

Of 179,854 GBM patients, 6,941 (4.2%) were YAs. Compared with older adults, YAs were more likely to be non-White (19.9% vs. 10.8%), uninsured (5.9% vs. 2.2%), and treated at academic centers (75.9% vs. 68.0%). YAs more frequently underwent gross total resection (30.0% vs. 25.1%) and received the Stupp regimen (58.8% vs. 46.0%). Median OS time was significantly longer in YAs (25.8 vs. 11.4 months, p < 0.001), with 5-year survival probabilities of 30.6% for YAs vs. 5.0% for older adults. Multivariable analysis confirmed that YA status was independently associated with improved OS (hazard ratio = 0.43, p < 0.001).

Conclusion

YA GBM patients experience better survival and receive more aggressive treatment than older adults. These findings support the need for age-adapted therapeutic strategies and highlight the importance of integrating molecular profiling and survivorship planning in YA GBM care.