{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:06Z","timestamp":1791352206922,"version":"4.3.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glioblastoma (GBM) has highly heterogeneous postoperative survival. Although contemporary prognostic assessment ideally requires molecular, functional, and surgical-detail variables, these data are often unavailable in population-based and multicenter real-world datasets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults with histologically recorded GBM and tumor-directed surgery (resection or biopsy) in SEER formed the derivation cohort. A multivariable Cox model estimated 6-, 12-, and 18-month overall survival and was externally evaluated in CGGA and an independent institutional cohort without refitting. Because extent of resection, biopsy details, performance status, MGMT promoter methylation, IDH status, and treatment-regimen details were unavailable or non-harmonizable, the model was explicitly intended for registry-based survival stratification when contemporary core prognostic variables are absent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 3, 842 patients in the SEER derivation cohort, 512 in the CGGA validation cohort, and 96 in the institutional validation cohort. Age, marital status, year of diagnosis, tumor location, tumor size, radiotherapy, and chemotherapy were retained in the final model. The model showed acceptable discrimination and calibration in the derivation cohort and reproducible risk stratification in both validation cohorts. In the independent non-public institutional validation cohort, the 6-, 12-, and 18-month AUCs were 0.748, 0.721, and 0.694, respectively, with a Harrell\u2019s C-index of 0.708, supporting reproducible risk stratification in a real-world clinical patient cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This multicohort study developed a registry-compatible survival stratification model for surgically managed glioblastoma for GBM using routinely available variables. The model may support survival estimation under data-constrained conditions, but should not be interpreted as a comprehensive neuro-oncology prognostic system or treatment decision-support tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1908021","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:52:49Z","timestamp":1791348769000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A data-constrained survival stratification model for surgically managed glioblastoma across public and real-world cohorts"],"prefix":"10.3389","volume":"16","author":[{"given":"Lin","family":"Zeng","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DingJun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengyu","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxing","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisha","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qizheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1089\/ther.2023.0014","article-title":"Therapeutic hypothermia in treating glioblastoma: a review","volume":"14","author":"Malliou","year":"2024","journal-title":"Ther Hypothermia Temp Manag"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.0023","article-title":"Glioblastoma and other primary brain malignancies in adults: a review","volume":"329","author":"Schaff","year":"2023","journal-title":"Jama"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043330","article-title":"Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma","volume":"352","author":"Stupp","year":"2005","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/molecules14041561","article-title":"Temozolomide with radiation therapy in high grade brain gliomas: pharmaceuticals considerations and efficacy; a review article","volume":"14","author":"Koukourakis","year":"2009","journal-title":"Molecules"},{"key":"B5","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s13000-019-0802-8","article-title":"Applications of molecular neuro-oncology - a review of diffuse glioma integrated diagnosis and emerging molecular entities","volume":"14","author":"Wood","year":"2019","journal-title":"Diagn Pathol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.01051","article-title":"The nomogram model predicting overall survival and guiding clinical decision in patients with glioblastoma based on the seer database","volume":"10","author":"Li","year":"2020","journal-title":"Front Oncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"9321","DOI":"10.1038\/s41598-021-88820-5","article-title":"Competing risk model to determine the prognostic factors and treatment strategies for elderly patients with glioblastoma","volume":"11","author":"Liu","year":"2021","journal-title":"Sci Rep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.pharmthera.2015.05.005","article-title":"Glioblastoma multiforme: pathogenesis and treatment","volume":"152","author":"Alifieris","year":"2015","journal-title":"Pharmacol Ther"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab106","article-title":"The 2021 who classification of tumors of the central nervous system: a summary","volume":"23","author":"Louis","year":"2021","journal-title":"Neuro Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-020-00447-z","article-title":"Eano guidelines on the diagnosis and treatment of diffuse gliomas of adulthood","volume":"18","author":"Weller","year":"2021","journal-title":"Nat Rev Clin Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1611977","article-title":"Short-course radiation plus temozolomide in elderly patients with glioblastoma","volume":"376","author":"Perry","year":"2017","journal-title":"N Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2020.1828867","article-title":"Current clinical management of elderly patients with glioma","volume":"20","author":"Pellerino","year":"2020","journal-title":"Expert Rev Anticancer Ther"},{"key":"B13","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1097\/00130404-200305000-00002","article-title":"Glioblastoma multiforme: introduction","volume":"9","author":"Markert","year":"2003","journal-title":"Cancer J"},{"key":"B14","article-title":"Glioblastoma multiforme","volume":"44","author":"Williams","year":"2014","journal-title":"J Insur Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1056\/NEJMoa043331","article-title":"MGMT gene silencing and benefit from temozolomide in glioblastoma","volume":"352","author":"Hegi","year":"2005","journal-title":"N Engl J Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1080\/14728222.2020.1762568","article-title":"Glioblastoma multiforme: novel therapeutic targets","volume":"24","author":"Muir","year":"2020","journal-title":"Expert Opin Ther Targets"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70025-7","article-title":"Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial","volume":"10","author":"Stupp","year":"2009","journal-title":"Lancet Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.5114\/wo.2014.40559","article-title":"Glioblastoma multiforme - an overview","volume":"18","author":"Urbanska","year":"2014","journal-title":"Contemp Oncol (Pozn)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1007\/s11940-009-0033-5","article-title":"Glioblastoma multiforme","volume":"11","author":"Welch","year":"2009","journal-title":"Curr Treat Options Neurol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"118","DOI":"10.3390\/v17010118","article-title":"Gene therapy for glioblastoma multiforme","volume":"17","author":"Shah","year":"2025","journal-title":"Viruses"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2019.00065","article-title":"Dexamethasone in glioblastoma multiforme therapy: mechanisms and controversies","volume":"12","author":"Cenciarini","year":"2019","journal-title":"Front Mol Neurosci"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-011-0749-4","article-title":"Glioblastoma survival in the United States before and during the temozolomide era","volume":"107","author":"Johnson","year":"2012","journal-title":"J Neuro-Oncol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"iii1","DOI":"10.1093\/neuonc\/noab200","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014-2018","volume":"23","author":"Ostrom","year":"2021","journal-title":"Neuro Oncol"},{"key":"B24","first-page":"3","article-title":"Biomarkers for glioblastoma multiforme: status quo","volume":"2","author":"Montano","year":"2016","journal-title":"J Clin Transl Res"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1908021\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:52:50Z","timestamp":1791348770000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1908021\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":24,"alternative-id":["10.3389\/fonc.2026.1908021"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1908021","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"article-number":"1908021"}}