GlioCova: Treatment and hospital admissions for patients with GBM in England

Abstract Aims Data on the treatment and outcomes of patients with primary brain tumours in England is sparse. The GlioCova project uses linked national data from England to explore the incidence, treatment, outcomes, and treatment costs of all adult brain tumour patients in all 50,000 patients in England from 2013 – 2018. Here we present initial results from patients with glioblastoma (GBM). Method We used a linked dataset from the national cancer registration system in England including all adult patients diagnosed with a malignant or benign brain tumour between 2013 and 2018 (51,775 patients in total). Glioblastoma patients were selected based on ICD-10 codes (C70, C71, C72), morphology codes (9440, 9441, 9442), and grade (G4, G3, GX and NA) from the national cancer registry. We extracted data on treatment (radiotherapy, chemotherapy, brain surgery or biopsy) and measured how many patients who had adjuvant Temozolomide completed 6 cycles. Results We identified 15,294 glioblastoma patients. Most had glioblastoma morphology (14,924), followed by gliosarcoma (264) and giant cell glioblastoma (106). Almost all had a cranial tumour (C71) while 17 had a tumour originating in the spinal cord, cranial nerves or other part of central nervous system (C72). Median age was 66 (IQR=17) and 60% were male. 51.9% (7,935) underwent surgery; an additional 18.2% (2,784) had a biopsy; 3,701 (24.2%) out of 15,294 patients received radiotherapy (only) and 316 (2.1%) received chemotherapy (only). 5,520 (36.1%) received both radiotherapy and chemo. Out of 4,101 GBM patients receiving temozolomide after radiotherapy, only 1,535 (37.4%) completed 6 cycles. The 7,935 GBM patients who had surgery had a median length of stay in hospital of 5 days (IQR=6) while those that had a biopsy had a median of 3 days (IQR=6). Conclusion We have presented a description of treatment of all GBM patients in England over a five-year period. This is the first time we have been able to understand detailed treatment patterns at a national scale, and significantly extends previous analyses. Further work will look at patient safety indicators, variation across centres and costs of treatment. Acknowledgements We would like to thank the GlioCova Expert Advisory Group for their input and discussion. This work uses data provided by patients and collected by the NHS as part of their care and support.

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P14.45 The incidence of major subtypes of primary brain tumours in adults in England 1995–2017

Neuro-Oncology ◽

10.1093/neuonc/noab180.160 ◽

2021 ◽

Vol 23 (Supplement_2) ◽

pp. ii46-ii47

Author(s):

H Wanis

Keyword(s):

Brain Tumour ◽

Brain Tumours ◽

Incidence Rates ◽

Diagnostic Tools ◽

Cancer Registration ◽

Molecular Testing ◽

Malignant Tumours ◽

Primary Brain Tumours ◽

Primary Brain Tumour ◽

European Standard Population

Abstract BACKGROUND Primary brain tumours are a complex heterogenous group of benign and malignant tumours. Reports on their occurrence in the English population by sex, age, and morphological subtype and on their incidence are currently not available. Using data from the National Cancer Registration and Analysis Service (NCRAS), the incidence of adult primary brain tumour by major subtypes in England will be described. METHODS Data on all adult English patients diagnosed with primary brain tumour between 1995 and 2017, excluding spinal, endocrinal and other CNS tumours, were extracted from NCRAS. Incidence rates were standardised to the 2013 European Standard Population. Results are presented by sex, age, and morphological subtype. RESULTS Between 1995 and 2017, a total of 133,669 cases of adult primary brain tumour were registered in England. Glioblastoma was the most frequent tumour subtype (31.8%), followed by meningioma (27.3%). The age-standardised incidence for glioblastoma increased from 3.27 per 100,000 population per year in 1995 to 7.34 in men in 2013 and from 2.00 to 4.45 in women. Meningioma incidence also increased from 1.89 to 3.41 per 100,000 in men and from 3.40 to 7.46 in women. The incidence of other astrocytic and unclassified brain tumours declined between 1995 and 2007 and remained stable thereafter. CONCLUSION Part of the increase in the incidence of major subtypes of brain tumours in England could be explained by advances in clinical practice including the adoption of new diagnostic tools, classifications and molecular testing, and improved cancer registration practices.

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Mortality due to primary brain tumours in China and detection rate in people with suspected symptoms: a nationally representative cross-sectional survey

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02179-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Bin Jiang ◽

Hongmei Liu ◽

Dongling Sun ◽

Haixin Sun ◽

Xiaojuan Ru ◽

...

Keyword(s):

Brain Tumour ◽

Brain Tumours ◽

Detection Rate ◽

Epidemiological Data ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Detection Rates ◽

Primary Brain Tumours ◽

Symptom Screening ◽

Nationally Representative

Abstract Background and purpose Epidemiological data on primary brain tumours (PBTs) are lacking due to the difficulty in case ascertainment among the population. Thus, we aimed to estimate mortality due to PBTs in China nationwide and the detection rate in people with suspected symptoms. Methods A multistage, complex sampling survey regarding mortality due to PBTs in Chinese individuals was carried out by reviewing all causes of death within a year. The detection rates in people with suspected symptoms were estimated based on PBT symptom screening and neurologist reviews and compared between groups by logistic regression analysis. Results Weighted mortality due to PBT was 1.6 (0.8–3.3) per 100,000 population in Chinese individuals, 1.8 (0.7–4.6) per 100,000 population in men, and 1.5 (0.5–4.5) per 100,000 population in women. Among 14,990 people with suspected symptoms, the PBT detection rate was 306.9 (95% CI 224.7–409.3) per 100,000 population in the total population, 233.0 (95% CI 135.7–373.1) per 100,000 population in men, and 376.9 (95% CI 252.4–546.3) per 100,000 population in women. People with an unsteady gait (OR 2.46; 95% CI 1.09–5.51; P=0.029), visual anomalies (3.84; 1.88–7.85; P<0.001), and headache (2.06; 1.10–3.86; P=0.023) were more likely to have a brain tumour than those without corresponding symptoms, while people with dizziness/vertigo were less likely to have a brain tumour than those without corresponding symptoms (0.45; 0.23–0.87; P=0.017). Conclusions Mortality due to PBT in China was low, with a nationwide estimate of 21,215 (10,427–43,165) deaths attributable to PBTs annually. However, the detection rate of PBTs can be greatly improved based on symptom screening in the population.

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Creating a nationwide cancer registration system to support AIDS-cancer match studies in Nigeria

Infectious Agents and Cancer ◽

10.1186/1750-9378-7-s1-p3 ◽

2012 ◽

Vol 7 (S1) ◽

Author(s):

Clement Adebamowo ◽

Elima Jedy-Agba ◽

Emmanuel Oga ◽

Peju Osinubi ◽

Festus Igbinoba ◽

...

Keyword(s):

Cancer Registration ◽

Registration System

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The impact of the environment on patient experiences of hospital admissions in palliative care

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2015-000891 ◽

2015 ◽

Vol 8 (4) ◽

pp. 485-492 ◽

Cited By ~ 6

Author(s):

Jackie Robinson ◽

Merryn Gott ◽

Clare Gardiner ◽

Christine Ingleton

Keyword(s):

Palliative Care ◽

Health Professionals ◽

Hospital Admissions ◽

Hospital Setting ◽

Prognostic Indicators ◽

Care Needs ◽

Acute Hospitals ◽

Almost All ◽

The Impact ◽

Palliative Care Needs

ObjectiveTo explore the impact of environment on experiences of hospitalisation from the perspective of patient's with palliative care needs.MethodsA qualitative study design using longitudinal semistructured, face-to-face interviews were used to elicit the views of patients with palliative care needs admitted to hospital in 1 large urban acute hospital in New Zealand. The sample comprised of 14 patients admitted to hospital between July 2013 and March 2014 who met one of the Gold Standard Framework Prognostic Indicators for palliative care need.ResultsAlmost all participants described a range of factors associated with the environment which impacted negatively on their experiences of hospitalisation. This included challenges with the physical surroundings, the impact on social relationships with other patients, families and health professionals and the influence of the cultural milieu of the hospital setting.ConclusionsEmulating the ‘ideal’ environment for palliative care such as that provided in a hospice setting is an unrealistic goal for acute hospitals. Paying attention to the things that can be changed, such as enabling family to stay and improving the flexibility of the physical environment while improving the social interplay between patients and health professionals, may be a more realistic approach than replicating the hospice environment in order to reduce the burden of hospitalisations for patients with palliative care needs.

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Preoperative brain mapping using [ 15 O]water activation PET provides evidence on altered language networks in an adult brain tumour patient

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-002-0993-0 ◽

2002 ◽

Vol 29 (12) ◽

pp. 1705-1705 ◽

Cited By ~ 1

Author(s):

Philipp Meyer ◽

Laszlo Sturz ◽

Osama Sabri ◽

Udalrich Buell

Keyword(s):

Brain Tumour ◽

Brain Mapping ◽

Adult Brain ◽

Water Activation ◽

Brain Tumour Patient ◽

Tumour Patient

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Cancer registration system: an introduction

International Journal of Clinical Oncology ◽

10.1007/s10147-014-0758-3 ◽

2014 ◽

Vol 20 (1) ◽

pp. 3-4

Author(s):

Tomotaka Sobue

Keyword(s):

Cancer Registration ◽

Registration System

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Developing guidelines for the management of brain tumour related epilepsy

Neuro-Oncology ◽

10.1093/neuonc/noab195.007 ◽

2021 ◽

Vol 23 (Supplement_4) ◽

pp. iv3-iv4

Author(s):

Elizabeth Vacher ◽

Miguel Rodriguez Ruiz ◽

Jeremy Rees

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Brain Tumour ◽

Brain Tumours ◽

Current Evidence ◽

Low Grade ◽

Clinical Nurse Specialists ◽

Primary Brain Tumours ◽

Low Incidence

Abstract Aims Brain Tumour Related Epilepsy (BTRE) has a significant impact on Quality of Life with implications for driving, employment and social and domestic activities. Management of BTRE is complex due to the higher incidence of pharmacoresistance and the potential for interaction between anti-cancer therapy and anti-epileptic drugs (AEDs). Neurologists, oncologists, palliative care physicians and clinical nurse specialists treating these patients would benefit from up-to-date clinical guidelines. We aim to review the current evidence to adapt current NICE guidelines for Epilepsy and to outline specific recommendations for the optimal treatment of BTRE, encompassing both primary and metastatic brain tumours. Method A comprehensive search of the literature from the past 20 years on BTRE was carried out in three databases: Embase, Medline and EMCARE. A broad search strategy was used and the evidence was evaluated and graded based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Results All patients with BTRE should be treated with AEDs. There is no proven benefit for the use of prophylactic AEDs, although there are no randomised trials testing newer agents. Seizure frequency varies between 10-40% (Class 2a evidence) in patients with Brain Metastases (BM) and from 30% (high-grade gliomas) to 90% (low-grade gliomas) (Class 2a evidence) in patients with Primary Brain Tumours (PBT). In patients with BM, risk factors include number of BM and melanoma histology (Class 2b evidence). In patients with PBT, risk factors include frontal and temporal location, oligodendroglial histology, IDH mutation and cortical infiltration (Class 2b evidence). There is a low incidence of seizures (13%) after stereotactic radiosurgery for BM (Class 2b evidence). Non-enzyme inducing AEDs are recommended as first line treatment for BTRE, but up to 50% of patients with BTRE due to PBT remain resistant (Class 2b evidence). Conclusion The review has highlighted the relative dearth of high quality evidence for the management of BTRE, and provides a framework for further studies aiming to improve seizure control, quality of life, and indications for AEDs.

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The quality of histopathology data in a computerised cancer registration system: implications for future audit of care

Public Health ◽

10.1038/sj.ph.1900337 ◽

1997 ◽

Vol 111 (2) ◽

pp. 101-103

Author(s):

S M Moss ◽

J A E Smith ◽

D S Nicholas

Keyword(s):

Cancer Registration ◽

Registration System

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Tratamento medicamentoso e não medicamentoso de usuários de um Centro de Atenção Psicossocial

Scientia Medica ◽

10.15448/1980-6108.2017.4.28277 ◽

2017 ◽

Vol 27 (4) ◽

pp. 28277

Author(s):

Laura Lorenzini Zanetti ◽

Eniva Stumm ◽

Fabiana Garlet Bosse ◽

Rosilda Oliveira ◽

Vanessa Adelina Casali Bandeira ◽

...

Keyword(s):

Elementary Education ◽

Pharmacological Treatment ◽

Hospital Admissions ◽

Care Center ◽

Psychosocial Care ◽

Direct Access ◽

Chi Square ◽

Cross Sectional ◽

Significance Level ◽

Almost All

AIMS: To verify the profile of pharmacological and non-pharmacological treatment of patients assisted in a Psychosocial Care Center.METHODS: An epidemiological study with a cross-sectional design was carried out in a Psychosocial Care Center of a municipality in the Northwest of the State of Rio Grande do Sul. All patients assisted in the Center, aged over 18 years, of both genders, were included. Those for whom information about treatment was missing were excluded. Data collection was performed by direct access to medical records regarding sociodemographic characteristics, information on diagnosis, previous hospital admissions, pharmacological and non-pharmacological treatment. Data analysis was performed using the Pearson Chi-square test and the significance level was set at p<0.05.RESULTS: A total of 448 patients were included, whose mean age was 48.25±12.44 years, 293 (65.4%) were female, 266 (59.2%) lived without a partner and 206 (46.0%) had incomplete elementary education. All patients were receiving non-pharmacological treatment and 445 (99.3%) were also taking medications. Among the classes of drugs used, antipsychotics (78.3%) and antidepressants (71.2%) predominated. Using of four or more drugs was associated with previous hospitalization and with taking antipsychotics, antidepressants, antiepileptics and anxiolytics.CONCLUSIONS: A sociodemographic profile similar to that of users of Psychosocial Care Centers in different Brazilian regions was found. All patients received non-pharmacological treatment and almost all also used drugs. In view of the high number of medications and hospital admissions identified, there is a need to expand the scope of non-pharmacological therapies in the treatment of mental disorders, in order to promote the comprehensiveness and the resolubility of mental health care.

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