Literature DB >> 21942727

Glioblastoma therapy in the elderly and the importance of the extent of resection regardless of age.

Agi Oszvald1, Erdem Güresir, Matthias Setzer, Hartmut Vatter, Christian Senft, Volker Seifert, Kea Franz.   

Abstract

OBJECT: The objective of this study was to analyze whether age influences the outcome of patients with glioblastoma and whether elderly patients with glioblastoma can tolerate the same aggressive treatment as younger patients.
METHODS: Data from 361 consecutive patients with newly diagnosed cerebral glioblastoma (2000-2006) who underwent regular follow-up evaluation from initial diagnosis until death were prospectively entered into a database. Patients underwent resection (complete, subtotal, or partial) or biopsy, depending on tumor size, location, and Karnofsky Performance Scale score. Following surgery, all patients underwent adjuvant treatment consisting of radiotherapy, chemotherapy, or combined treatment. Patients older than 65 years of age were defined as elderly (146 total).
RESULTS: Two hundred thirty-four patients underwent tumor resection (complete 26%, subtotal 29%, and partial 45%). One hundred twenty-seven underwent biopsy. Mean patient age was 61 years, and overall survival was 11.6 ± 12.1 months. The overall survival of elderly patients (9.1 ± 11.6 months) was significantly lower than that of younger patients (14.9 ± 16.7 months; p = 0.0001). Stratifying between resection or biopsy, age was a negative prognostic factor in patients undergoing biopsy (4.0 ± 7.1 vs 7.9 ± 8.7 months; p = 0.007), but not in patients undergoing tumor resection (13.0 ± 8.5 vs 13.3 ± 14.5 months; p = 0.86). Survival of elderly patients undergoing complete tumor resection was 17.7 ± 8.1 months.
CONCLUSIONS: In this series of patients with glioblastoma, age was a prognostic factor in patients undergoing biopsy, but not in patients undergoing resection. Tumor location and patient clinical status may prohibit extensive resection, but resection should not be withheld from patients only on the basis of age. In elderly patients with glioblastoma, undergoing resection to the extent feasible, followed by adjuvant therapies, is warranted.

Entities:  

Mesh:

Year:  2011        PMID: 21942727     DOI: 10.3171/2011.8.JNS102114

Source DB:  PubMed          Journal:  J Neurosurg        ISSN: 0022-3085            Impact factor:   5.115


  50 in total

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2.  Treatment outcomes in glioblastoma patients aged 76 years or older: a multicenter retrospective cohort study.

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3.  Novel Surgical Approaches to High-Grade Gliomas.

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5.  Treatment of glioblastoma in elderly patients.

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6.  Prognostic paradox: brain damage around the glioblastoma resection cavity.

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Review 7.  Management of elderly patients with gliomas.

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Journal:  Oncologist       Date:  2014-10-23

8.  Surgical treatment of glioblastoma in the elderly: the impact of complications.

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9.  One decade of glioblastoma multiforme surgery in 342 elderly patients: what have we learned?

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Review 10.  Surgical resection of malignant gliomas-role in optimizing patient outcome.

Authors:  Ilker Y Eyüpoglu; Michael Buchfelder; Nic E Savaskan
Journal:  Nat Rev Neurol       Date:  2013-01-29       Impact factor: 42.937

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