gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Should recurrent malignant glioma be operated in the elderly?

Sollten Rezidive maligner Gliome beim älteren Patienten operiert werden?

Meeting Abstract

Suche in Medline nach

  • corresponding author M. Dymora - Department of Neurosurgery, University Hospital of Dresden, Dresden
  • S. B. Sobottka - Department of Neurosurgery, University Hospital of Dresden, Dresden
  • G. Schackert - Department of Neurosurgery, University Hospital of Dresden, Dresden

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-17.06

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0087.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Dymora et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The indication for surgical treatment of recurrent glioma is controversial. Usually, the decision is based on age, neurological condition prior to surgery and time interval between initial surgery and tumour recurrence. We retrospectively compared the surgical outcome of patients with malignant gliomas younger and older than 60 years in order to evaluate whether elderly patients benefit from recurrent surgery.

Methods

42 malignant glioma patients (28 males, 14 females; 7 WHO°III, 35 WHO°IV) underwent surgery for recurrent tumour growth between 1995 and 1999. Surgical outcome (survival and time interval with Karnofsky ≥70) was compared between 31 patients younger and 11 patients older than 60 years. 29/31 patients (<60y) and 7/11 patients (≥60y) had a Karnofsky index ≥70 prior to recurrent surgery. Time interval between initial and recurrent surgery ranged between 4.3–67.2 months (median 16.5; n=6 WHO°III) and 1.5–51.7 months (median 9.4; n=25 WHO°IV) for the younger age group and 1.6 months (n=1 WHO°III) and 4.5–41.0 months (median 8.7; n=10 WHO°IV) for the older age group.

Results

24/31 patients <60y and 10/11 patients ≥60y had an equal or better neurological outcome after recurrent surgery. 22/31 patients <60y and 10/11 patients ≥60y additionally received adjuvant treatment. The survival was 0.4–46.5 months (median 6.8) for 31 patients <60y and 1.2–22.7 months (median 5.0) for 11 patients ≥60y, respectively. 5/31 received surgery for a second tumour recurrence after a time interval of 3.2–27.4 months, median 4.9 month (survival after second operation 1.4–10.6 months – median 5.5). 27/31 patient <60y and 7/11 patients ≥60y maintained a Karnofsky ≥70 for a time interval of 0.3 – 33.0 months (median 5.8) and 1.0–12.4 months (median 3.2), respectively. Total survival after initial surgery was 14.8–113.7 months (median 27.2; <60y) and 6.6 months (≥60y) for glioma WHO°III and 7.1–57.3 months (median 17.5; <60y) and 8.5–63.7 months (median 15.4; ≥60y) for glioma WHO°IV.

Conclusions

Patients with recurrent malignant gliomas in good initial neurological condition may profit from surgical and adjuvant treatment. Although older patients usually demonstrated an unfavourable outcome, surgery may be an option in certain patients in good clinical condition.