gms | German Medical Science

Objective: Young age is a known beneficial prognostic factor for patients with glioblastoma (GBM). However, it remains unclear, whether this relies on a potentially more favourable biological background of these patients or on the presumably more aggressive care applied to them.

Method: We retrospectively analyzed 471 consecutive patients with de novo GBM focusing on clinical and tumor characteristics as well as on treatment modalities. Additionaly, the younger population was also studied for MGMT/ IDH1 status.

Results: Young age was identified as an independent predictor for overall survival (OS) and progression free survival (PFS) (age ≤50 vs. >50 yrs.: OS: 33 months and PFS: 16 months vs. OS: 14 months and PFS: 8 months, p<0.001). Extent of resection and radiotherapy did not differ between the age groups. However, younger patients were more likely to receive chemotherapy (p=0.009). Mutant IDH1 and MGMT methylation status were detected in 16.9%, and 39.1%, respectively. The mutant IDH1 status was identified as prognostic factor for both, OS (p=0.040) and PFS (p=0.045) in the younger population. Tumors of long-term survivors (>3 yrs) contained IDH1 mutation more often (p=0.013) than the tumors of the remaining patients.

Conclusions: Glioblastomas of younger patients seem to possess a more favourable molecular profile which may contribute to their better prognosis. The IDH1 mutation in our younger cohort was detected more frequently compared to the rates reported in the general population before, and correlates with survival also in the younger population.