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Management of glioma in Victoria (1998-2000): retrospective cohort study
Mark A Rosenthal1, Katharine J Drummond, Michael Dally
1Royal Melbourne Hospital, Parkville, VIC. mark.rosenthal@mh.org.au
Objective:
To describe the management of and outcomes in a population-based cohort of patients with newly diagnosed glioma.
Design, Setting And Patients:
Retrospective cohort study of patients with glioma newly diagnosed over the period 1998-2000 in Victoria. Patients were identified from the population-based Victorian Cancer Registry (VCR). Doctors involved in managing the patients were surveyed by a questionnaire sent out in 2003. The cohort was followed until the end of 2004 to obtain at least 4 years' follow-up data on all patients.
Main Outcome Measures:
Reported treatment, referral patterns and survival rates.
Results:
Over the study period, 992 cases of glioma were identified; 828 completed surveys on eligible patients were obtained (response rate, 93%); 473 patients (57%) had glioblastoma multiforme (GBM); 105 patients (13%) diagnosed with "glioma" had had no histological confirmation. Complete macroscopic resection was performed in 209 patients (25%); 612 patients (74%) were referred for radiotherapy and 326 (54%) for chemotherapy; 39 (5%) were enrolled on a clinical trial. Median survival was 9.2 months for all patients and 7.4 months for patients with GBM.
Conclusions:
This is the largest reported glioma management survey in the world to date. Much of the patient demographics and approach to treatment were as expected and represent a reasonable "standard of care". However, there are some areas for improvement, including the absence of histological diagnosis in some patients, lack of multidisciplinary care, low clinical trial enrollment and poor use of ancillary services.
