Butterfly glioblastoma: trends in therapeutic modalities, extent of resection and survival in the temozolomide era. a SEER-based study
Bibliographic record
Abstract
Butterfly glioblastoma (bGBM) is a rare type of GBM, thought to have extremely poor outcome and is generally considered "inoperable". The aim of this study was to investigate survival outcomes in bGBM over a long period, and to look for potential benefits of gross total resection (GTR). The data of 521 bGBM patients diagnosed between 2000 and 2021 from the Surveillance, Epidemiology, and End Results (SEER) database were obtained. The cohort was divided into 3 subgroups based on the year of diagnosis: pre-temozolomide era (pre-TMZ; 2000-2006), early TMZ era (2007-2016) and late TMZ era (2017-2021). chemotherapy was significantly more common in the TMZ group (51.9% vs. 36%, p = 0.007). The TMZ group was associated with nearly significantly improved OS (HR = 0.795, p = 0.067). On multivariate analysis, only radiation therapy was associated with improved survival in the pre-TMZ group (HR = 3.029, p = 0.001). However, in the TMZ group, 4 variables were associated with improved survival: chemotherapy (HR = 1.523, p = 0.049), radiation therapy (HR = 1.676, p = 0.006), surgery (HR = 1.402, p = 0.004) and age (HR = 1.031, p < 0.001). Both subtotal resection and GTR were significantly associated with favorable prognosis when compared to no surgery (HR = 0.607, p < 0.001 and HR = 0.467, p < 0.001; respectively). The rate of GTR was significantly higher in the late TMZ group (19.2% vs. 10.2%, p = 0.0013). GTR was significantly associated with improved OS in the late TMZ subgroup (HR = 1.846, p = 0.028). bGBM cases in the TMZ era are associated with increased rate of adjuvant chemotherapy as well as with improved OS, in comparison to pre-TMZ cases. The rate of GTR cases has significantly increased in recent years, and is associated with significantly increased rate of post operative adjuvant therapy. GTR patients who have received any kind of adjuvant therapy had significantly better OS when compared to non-GTR patients. bGBM should be treated like other operable GBM cases, using the appropriate, advanced surgical techniques. Clinical trial number: Not applicable.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| 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".