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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

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The geriatric glioblastoma - Do not touch or operate?

Der geriatrische Glioblastom-Patient - Finger weg oder operieren?

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  • corresponding author Christian Rainer Wirtz - Neurochirurgische Klinik, Ruprecht-Karls-Universität, Heidelberg
  • M. M. Bonsanto - Neurochirurgische Klinik, Ruprecht-Karls-Universität, Heidelberg
  • V. M. Tronnier - Neurochirurgische Klinik, Ruprecht-Karls-Universität, Heidelberg
  • H. H. Steiner - Neurochirurgische Klinik, Ruprecht-Karls-Universität, Heidelberg
  • A. Aschoff - Neurochirurgische Klinik, Ruprecht-Karls-Universität, Heidelberg
  • S. Kunze - Neurochirurgische Klinik, Ruprecht-Karls-Universität, Heidelberg
  • A. Unterberg - Neurochirurgische Klinik, Ruprecht-Karls-Universität, Heidelberg

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.02.12

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0257.shtml

Published: April 23, 2004

© 2004 Wirtz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

Surgery for glioblastoma is discussed controversially and even more so in geriatric patients. To provide evidence to decide on this issue an analysis of patients aged 65 or older undergoing glioblastoma surgery was performed.

Methods

Out of 104 patients that were analyzed regarding the impact of radicality on survival in operations for glioblastoma 24 patients aged 65 or older were followed postoperatively. Postoperative clinical findings as well as progression free and overall survival were obtained. The extent of resection was assessed with early postoperative MRI.

Results

Mean age was 70,2 ± 3,3 years with a range from 65 to 76 and mean preoperative Karnofsky score was 70,1 ± 7,8 (range 70-90). Postoperative MRI revealed residual tumour in 18, uncertain findings in 2 and radical resection in 4 cases. Median survival was 11,2 months for all (range 1,1 - 28 months), 13 mo. for radically operated and 8,8 mo. for patients with residual tumour, the difference being not significant. Clinically 8 patients improved, 7 were unchanged and 9 deteriorated postoperatively resulting in a mean postoperative Karnofsky of 76,7 ± 16,6 (range 40-90). 5 patients (20,8%) had neurological deficits resulting in a Karnofsky score ≤50 in 3 (12,5%).

Conclusions

Age alone seems to be no contraindication to operate patients with glioblastoma with the goal to resect the tumour as completely as possible. Although morbidity seems to be somewhat increased patients seem to profit from an aggressive therapeutic approach. Nevertheless it is mandatory to carefully select patients and individually discuss the indication with each of them.