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School of Medicine


Glioblastoma is a fatal brain cancer with low median and yearly survival rates. The standard of care for treating glioblastoma is gross total resection (GTR) coupled with the Stupp protocol, but various factors influence the interventions undertaken and survival achieved. As health disparities exist in rural areas, survival in these areas need to be assessed in order to understand which factors detract from the successes of these standard medical interventions. We retrospectively determined the impact of age of diagnosis, number of lesions, the molecular marker O6-methylguanine methyltransferase (MGMT), extent of surgery, and completion of the Stupp protocol on survival among patients treated at West Virginia University Hospitals. We found that an age of diagnosis under 60 years, having the MGMT gene methylated, having a unifocal tumor, receiving GTR, adhering to the Stupp protocol, and undergoing a treatment course of GTR followed by the Stupp protocol significantly increased survival. Lastly, we compared our findings to a pre-Stupp study done in West Virginia in 1996. This comparison showed that although overall median survival has not increased, all interventions involving GTR have resulted in a significantly higher survival. We conclude that we can serve our patient population by offering GTR to all adult glioblastoma patients when no contraindications exist and ensuring that patients follow the Stupp protocol. After discharge, the Stupp protocol may not be followed/completed for a variety of reasons. In the future, we aim to assess these reasons and analyze other significant interventional and socioeconomic factors which influence survival.

Source Citation

Urhie O, Turner R, Lucke-Wold B, et al. Glioblastoma Survival Outcomes at a Tertiary Hospital in Appalachia: Factors Impacting the Survival of Patients Following Implementation of the Stupp Protocol. World Neurosurgery. 2018;115:e59-e66. doi:10.1016/j.wneu.2018.03.163