Beyond Molecular Characterization: The Impact of Age-Adjusted Charlson Comorbidity Index in Glioblastoma Patients Treated with Radio or Radio-Chemotherapy

TL;DR

This study shows that the age-adjusted Charlson Comorbidity Index can predict survival outcomes in glioblastoma patients undergoing radiotherapy or chemoradiotherapy.

Contribution

The study demonstrates that ACCI is an independent prognostic factor in newly diagnosed glioblastoma patients.

Findings

Patients with lower ACCI scores had significantly longer overall survival compared to those with higher scores.

The ACCI remained a significant predictor of survival in multivariate analysis.

Abstract

Background: Glioblastoma (GBM) prognosis has been reported to be influenced by age and comorbidity in several investigations. Identifying factors that contribute to poor survival is crucial to optimizing and personalizing therapeutic strategies. In the present retrospective analysis, we investigated the impact of GBM patient stratification using the age adjusted Charlson Comorbidity Index (ACCI). Methods: A total of 165 patients diagnosed with IDH wild-type GBM, treated with post-operative radio or radio-chemotherapy, were evaluated. To assess the impact of comorbidities, patients were stratified into two groups according to their ACCI scores: Group A (ACCI 0–2) and Group B (ACCI >2). The Cox proportional hazards model test was used to compare overall survival (OS) between the two groups of patients and determine whether the presence of comorbidities significantly affected outcomes. Primary and secondary endpoints were OS and progression free survival (PFS), respectively. Results: The median follow-up period was 36 months, and the median OS was 14 months (95% CI 12.4–15.5). The univariate analysis evidenced that patients in Group A had a significantly longer OS compared to those in Group B, with median OS times of 18 months (95% CI 16–20) and 12 months (95% CI 10.5–13.5), respectively (p = 0.015). The OS remained statistically significant in the multivariate analysis (p = 0.015). Conclusions: The results of this study indicate that ACCI may serve as an independent prognostic factor in patients with newly diagnosed GBM.

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