gms | German Medical Science

Objective: Resection of glioblastoma is a main prognostic factor for the patients' outcome. There are few data about the impact of surgical therapy in elderly patients on survival rates, also it is unclear at what age someone should be regarded as elderly. Therefore, we performed a retrospective analysis of our data focusing on elderly patients (>75 years) with glioblastoma (GBM) to evaluate the benefit of resection vs. conservative therapy.

Method: We performed a retrospective analysis of clinical and histological data of patients ≥ 75 years, who were treated for GBM between 2008 and 2012 at our institution. Multimodal treatment was individually planned by an interdisciplinary tumor board. For statistical analysis, we used Kaplan-Meier analysis and Log rank Test, as well as cox regression analysis for multivariate analysis.

Results: 59 patients with a median age of 78 (75 - 85) years were inlcuded. The median KPS was 80 (50 - 100). 17 Patients (28.8%) underwent tumor resection, 42 patients received no further surgical therapy after stereotactical biopsy. There was no significant difference between the median KPS of the two groups. The median survival for all patients was 5.0 months. Median survival was higher for patients with surgical treatment than for those without further surgical therapy (8.8 vs. 3.8 months, p<0.01). In the multivariate analysis, resection was the only significant factor (p<0.05) on overall survival. 3 patients received no further adjuvant therapy after resection because of clinical worsening after surgery. The median survival of those patients was 4.7 months, this did not differ significantly from the survival of the patients who underwent no further therapy after stereotactical biopsy (2.0 months, p=0.1).

Conclusions: Elderly gliobastoma patients profit from surgery combined with adjuvant therapy; however clinical worsening after surgery is possible. This should be taken into account in individual therapy planning.