INNV-34. PATTERNS OF FAILURE AND DEVELOPMENT OF A NOVEL PROGNOSTIC SCORING SYSTEM IN ELDERLY PATIENTS WITH GLIOBLASTOMA – FOLLOW UP ON 10 YEAR ANALYSIS OF THE BC CANCER AGENCY POPULATION
Bibliographic record
Abstract
Abstract PURPOSE Glioblastomas (GBM) are the most common primary brain tumour recurring in most patients despite maximal management. Patient selection for appropriate treatment modality remains challenging resulting in heterogeneity in management. We examined the patterns of failure and developed a scoring system for patient stratification to optimise clinical decision making. METHODS 822 adults (BC Cancer Agency registry) diagnosed 2005–2015 age ≥60 with histologically confirmed GBM ICD-O-3 codes (9440/3, 9441/3, 9442/3) were reviewed. Univariate and Kaplan-Meier analysis were performed. Performance status (PS), age and resection status were assigned a score, cummulative maximal (favorable) score of 10 and minimum (unfavorable) score of 3. Patterns of failure were further analysed in the subset of patients with radiographic follow-up. RESULTS PS score of 3(KPS >80, ECOG 0/1), 2 (KPS 60–70, ECOG 2), 1 (KPS < 60, ECOG 3/4) (median OS 11, 6, 3 months respectively), age score and resection status were prognostic for OS with PS resulting in the most significant curve separation (p< 0.0001). Biopsy as compared to STR/GTR resulted in poorer OS in patients over 70 (age score 1/2) but had less impact in patients younger than 70 (age scores 3/4). The median OS for cumulative scores of 9/10 (123 patients), 7/8 (286 patients), 5/6 (313 patients), and 3/4 (55 patients) were 14, 8, 4 and 2 months respectively (p< 0.0001) allowing for stratification into 4 prognostic groups. 133 patients had >3 MRIs following diagnosis allowing for clinical and radiographic analysis of progression. Clinical/radiographic progression occurred within 3 months (29%/45%), 6 months (50%/66%), 9 months (70%/81%). Progression type (radiographic, clinical, both was not associated with OS. CONCLUSION Our novel prognostic scoring system is effective in achieving patient stratification and may guide clinical decision making. Early radiographic progression appears to precede clinical deterioration and may represent true progression in the elderly.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".