Elderly patients aged over 75 years with glioblastoma: Preoperative status and surgical strategies

Background: Standards of care for the elderly with glioblastoma are still unknown, because most studies exclude elderly patients. The effects of preoperative status and surgical strategies on the prognosis for elderly glioblastoma patients were studied. Methods: We defined “elderly” as 75 years or o...

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Main Authors: Tadashi Osawa, Masahiko Tosaka, Keishi Horiguchi, Kenichi Sugawara, Hideaki Yokoo, Yuhei Yoshimoto
Format: Article
Language:English
Published: Elsevier 2021-09-01
Series:Interdisciplinary Neurosurgery
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214751921000396
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author Tadashi Osawa
Masahiko Tosaka
Keishi Horiguchi
Kenichi Sugawara
Hideaki Yokoo
Yuhei Yoshimoto
author_facet Tadashi Osawa
Masahiko Tosaka
Keishi Horiguchi
Kenichi Sugawara
Hideaki Yokoo
Yuhei Yoshimoto
author_sort Tadashi Osawa
collection DOAJ
description Background: Standards of care for the elderly with glioblastoma are still unknown, because most studies exclude elderly patients. The effects of preoperative status and surgical strategies on the prognosis for elderly glioblastoma patients were studied. Methods: We defined “elderly” as 75 years or older and retrospectively reviewed 137 patients with glioblastoma, including 31 (22.6%) elderly patients. Relationships between age and clinicopathological variables were investigated. Results: The median overall survival (OS) was 15.8 months in the nonelderly group and 10.8 months in the elderly group (p = 0.02). The median progression-free survival (PFS) was 9.1 months in the nonelderly group and 6.6 months in the elderly group (p = 0.02). Median OS and median PFS had no relationship between low (<70) and high (≥70) Karnofsky performance status (KPS) in the nonelderly group. However, the median OS was significantly longer in the elderly group with high KPS (8.4 months in low KPS, 12.4 months in high KPS; p = 0.003). The median PFS was also significantly longer in the elderly group with high KPS (4.3 months in low KPS, 9.1 months in high KPS; p = 0.04). OS and PFS were significantly longer in the nonelderly group with resection than with biopsy (OS, p = 0.016; PFS, p = 0.039). However, neither OS nor PFS showed any difference with surgical method in the elderly group (OS, p = 0.241; PFS, p = 0.131). Conclusions: Less invasive treatment can be considered as a treatment option in addition to radical resection in glioblastoma patients aged 75 years and older with KPS on admission of less than 70, depending on the general condition.
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spelling doaj.art-74a871876a19473ba9f9ea045906c6272022-12-21T22:15:10ZengElsevierInterdisciplinary Neurosurgery2214-75192021-09-0125101127Elderly patients aged over 75 years with glioblastoma: Preoperative status and surgical strategiesTadashi Osawa0Masahiko Tosaka1Keishi Horiguchi2Kenichi Sugawara3Hideaki Yokoo4Yuhei Yoshimoto5Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan; Corresponding author at: Department of Neurosurgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, JapanDepartment of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, JapanDepartment of Neurosurgery, University of the Ryukyus, Faculty of Medicine Hospital, Okinawa, JapanDepartment of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma, JapanDepartment of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, JapanBackground: Standards of care for the elderly with glioblastoma are still unknown, because most studies exclude elderly patients. The effects of preoperative status and surgical strategies on the prognosis for elderly glioblastoma patients were studied. Methods: We defined “elderly” as 75 years or older and retrospectively reviewed 137 patients with glioblastoma, including 31 (22.6%) elderly patients. Relationships between age and clinicopathological variables were investigated. Results: The median overall survival (OS) was 15.8 months in the nonelderly group and 10.8 months in the elderly group (p = 0.02). The median progression-free survival (PFS) was 9.1 months in the nonelderly group and 6.6 months in the elderly group (p = 0.02). Median OS and median PFS had no relationship between low (<70) and high (≥70) Karnofsky performance status (KPS) in the nonelderly group. However, the median OS was significantly longer in the elderly group with high KPS (8.4 months in low KPS, 12.4 months in high KPS; p = 0.003). The median PFS was also significantly longer in the elderly group with high KPS (4.3 months in low KPS, 9.1 months in high KPS; p = 0.04). OS and PFS were significantly longer in the nonelderly group with resection than with biopsy (OS, p = 0.016; PFS, p = 0.039). However, neither OS nor PFS showed any difference with surgical method in the elderly group (OS, p = 0.241; PFS, p = 0.131). Conclusions: Less invasive treatment can be considered as a treatment option in addition to radical resection in glioblastoma patients aged 75 years and older with KPS on admission of less than 70, depending on the general condition.http://www.sciencedirect.com/science/article/pii/S2214751921000396ElderlyGeriatricGlioblastoma
spellingShingle Tadashi Osawa
Masahiko Tosaka
Keishi Horiguchi
Kenichi Sugawara
Hideaki Yokoo
Yuhei Yoshimoto
Elderly patients aged over 75 years with glioblastoma: Preoperative status and surgical strategies
Interdisciplinary Neurosurgery
Elderly
Geriatric
Glioblastoma
title Elderly patients aged over 75 years with glioblastoma: Preoperative status and surgical strategies
title_full Elderly patients aged over 75 years with glioblastoma: Preoperative status and surgical strategies
title_fullStr Elderly patients aged over 75 years with glioblastoma: Preoperative status and surgical strategies
title_full_unstemmed Elderly patients aged over 75 years with glioblastoma: Preoperative status and surgical strategies
title_short Elderly patients aged over 75 years with glioblastoma: Preoperative status and surgical strategies
title_sort elderly patients aged over 75 years with glioblastoma preoperative status and surgical strategies
topic Elderly
Geriatric
Glioblastoma
url http://www.sciencedirect.com/science/article/pii/S2214751921000396
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