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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Neurological and medical morbidities after surgery for malignant astrocytomas are not significantly different in the elderly compared to younger patients

Patientenalter ohne Einfluss auf die postoperative neurologische und internistische Morbidität bei malignen Astrozytomen

Meeting Abstract

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  • corresponding author Ramon Martinez - Neurochirurgische Klinik, Klinikum Fulda, Pacelliallee 4, 36043 Fulda
  • B. Hölper - Neurochirurgische Klinik, Klinikum Fulda, Pacelliallee 4, 36043 Fulda
  • R. Behr - Neurochirurgische Klinik, Klinikum Fulda, Pacelliallee 4, 36043 Fulda

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMI.02.11

The electronic version of this article is the complete one and can be found online at:

Published: April 23, 2004

© 2004 Martinez et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Outcome of patients with malignant gliomas is associated with younger age. Elderly patients with GBM or anaplastic astrocytoma have been under-represented in the neuro-oncological studies conducted so far. The aim of this study was to evaluate early outcome after conventional surgical treatment of glioblastoma multiforme and anaplastic astrocytomas in the elderly (> 65 years) compared to younger patients (< 65 years).


One hundred and thirty-three consecutive patients with malignant gliomas were surgically treated between 1998 and 2003. There were 100 GBMs, 20 anaplastic astrocytomas and 13 anaplastic mixed gliomas. Only five patients with radiological suspected malignant glioma did not undergo surgery. Several clinical variables were analyzed: age, gender, pre- and postoperative KPS score, tumour location, preoperative neurological performance scale, pre- and postoperative morbidity. Mann-Whitney test was performed to compare median ages and KPS scores. Two-tailed Fisher´s exact test was used to evaluate differences of further variables between both patient groups.


The patients underwent 191 surgical procedures by open craniotomies (n= 167) or burr-hole tumour biopsy (n= 24). Fifty-six patients were ≥65-year-old (mean: 71 y., SD: 4.3 y.), one hundred and nine were < 65 (mean: 52 y., SD: 10.7 y.). A preoperative KPS score of < 70 was detected in 57.1% of the elderly- and 24.8% of the younger patients. Preoperative morbidities were observed in 60.7% and 19.3% of older- and younger patients, respectively being cardiovascular and endocrine-metabolic diseases most frequently represented in both cohorts. After surgery, neurological complications were found in 23.2% and 18.3% of the older- and younger patients, respectively (more frequently epileptic seizures and CSF-leak). Medical complications (mostly, pulmonary embolism and pneumonia) after surgical procedures were present in 16% in the elderly and 7.3% in younger patients. The mortality rates were 5.4% and 3.7% in the older and younger patients group, respectively. There were no significant differences between both groups concerning neurological (P=0.587) or medical complications (P=0.145), mortality rate (P=0.887), and KPS worsening after surgery (P=0.177). Strong significant differences were observed in the following variables: pre and post operative KPS score (both P=0.0001) and preoperative presence of morbidity (P=0.0001), specially cardio-vascular diseases (P=0.0001).


Age alone should not exclude the decision of an aggressive therapy in the elderly. Evaluation of clinical variables such as KPS status, burden of comorbidities, cognitive functions and tumour accessibility appears to be mandatory in order to choose which patients must not be deprived of an integrated treatment with surgery and adjuvant therapy.