gms | German Medical Science

60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Glioblastoma therapy in the elderly. Is extent of resection important for survival regardless of age?

Meeting Abstract

  • Á. Oszvald - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • E. Güresir - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • C. Senft - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • V. Seifert - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • K. Franz - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMI.09-07

DOI: 10.3205/09dgnc236, URN: urn:nbn:de:0183-09dgnc2361

Veröffentlicht: 20. Mai 2009

© 2009 Oszvald 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 vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: To analyze whether elderly patients with glioblastoma can tolerate the same aggressive treatment as younger patients and whether it affects survival time?

Methods: Data of 361 (male/female; 212/149) consecutive patients with histopathologically diagnosed cerebral glioblastoma with regular follow up from diagnosis to death from Januar 2000 to December 2006 were prospectively entered in a database. All patients underwent complete or partial resection or biopsy, depending on tumor size, location and general condition regardless of age. After the surgical treatment, all patients underwent radiation, chemotherapy or combined treatment and further therapies, if needed. Patients = 65 years (y) were defined as elderly. Patients were classified according to age, operative therapy (resection [complete: 100%, partial: =90%], biopsy), adjuvant treatment (radiotherapy, radiochemotherapy and none) gender and Karnofsky index.

Results: The overall survival after resection or biopsy in elderly patients (n: 146, mean: 71 y) was significantly lower than in younger patients (n: 215, mean: 57 y) (9.1 versus (vs.) 14.9 months, p=0.0001). Analyzing the subgroup of patients with at least partial resection, no difference in survival time (15.3 vs. 16.3 months) between elderly and younger patients could be found (p=0.6; OR 0.9, CI 0.6 – 1.3). Survival time in the multivariate analysis in the resection subgroup was only effected by no adjuvant treatment (shorter survival, p<0.0001, OR 0.2, CI 0.07 – 0.3) and female gender (longer survival, p=0.02, OR 1.5, CI 1.1 – 2.2). In contrast, elderly patients that underwent biopsy and further adjuvant therapy had a significantly shorter survival time (p=0.007). Adjuvant postoperative treatment (radiotherapy (RT), radiochemotherapy (RCT) or none) was distributed equally among the age groups (RT: p=1.0, RCT: p=0.5, none: p=0.2).

Conclusions: The current data suggest that resection to the extent feasible, followed by adjuvant therapies in elderly patients with glioblastoma is warranted. There was no significant difference in survival time due to age for patients undergoing resection. Therefore, aggressive tumor resection should be offered to all patients in good clinical conditions regardless of age.