Metabolics risk factors in a New Zealand glioblastoma cohort

Neurooncol Pract. 2021 Nov 12;9(1):43-49. doi: 10.1093/nop/npab064. eCollection 2022 Feb.

Abstract

Background: Glioblastoma multiforme (GBM) is the most aggressive form of glioma. There is growing recognition that mitochondrial metabolism plays a role in cancer development. Metabolic syndrome is a risk factor for several cancers; however, the prevalence in GBM patients in New Zealand (NZ) is unknown. We hypothesized that patients with GBM would show a higher prevalence of metabolic syndrome compared to the general NZ population and that metabolic syndrome may be associated with worsened overall survival (OS) in GBM.

Methods: We performed a retrospective analysis in 170 patients diagnosed and treated for GBM between 2005 and 2020. Clinical and biochemical data were collected with regard to 5 metabolic criteria. OS was determined from the date of initial surgical diagnosis to the date of death or date of data acquisition.

Results: Of 170 patients, 31 (18.2%) met the diagnostic criteria for metabolic syndrome. The prevalence of metabolic syndrome in our cohort did not significantly differ from that of the general NZ population. However, OS in patients with metabolic syndrome was significantly worse compared to patients without metabolic syndrome (8.0 vs 13.0 months, P = .016). Patients who received a lower dexamethasone dose had significantly better survival outcomes (15.0 vs 5.0 months, P < .01). Differences in OS did not differ by gender or ethnicity.

Conclusions: We have shown that metabolic syndrome is associated with reduced OS in a NZ cohort of GBM patients. This finding further strengthens the possibility that a metabolic pathogenesis may underpin GBM. However, prospective clinical trials are needed.

Keywords: dexamethasone; ethnicity; glioblastoma multiforme; metabolic syndrome; overall survival.