Article
Karnofsky Performance Score (KPS) and not age influences health related quality of life and distress in patients with high-grade gliomas – comparison of the younger vs. elderly patients of the ERASMUS study population
Der Karnofsky Performance Score (KPS) und nicht das Alter beeinflusst die gesundheitsbezogene Lebensqualität und die Belastung bei Patienten mit malignen Gliomen – ein Vergleich d. älteren vs. jüngeren ERASMUS-Studienpopulation
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Authors
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Mirjam Renovanz
- Unimedizin Mainz, Neurochirurgie, Mainz, Deutschland
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Anne-Katrin Hickmann
- Kantonspital St. Gallen, Neurochirurgie, St. Gallen, Switzerland
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Naureen Keric
- Unimedizin Mainz, Neurochirurgie, Mainz, Deutschland
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Elke Weimann
- Klinikum Ludwigsburg, Ludwigsburg, Deutschland
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Minou Nadji-Ohl
- Klinikum Stuttgart, Neurochirurgie, Stuttgart, Deutschland
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Florian Ringel
- Unimedizin Mainz, Neurochirurgie, Mainz, Deutschland
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Jan Coburger
- Universitätsklinik Ulm, Neurochirurgie, Ulm, Deutschland
| Published: | May 8, 2019 |
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Outline
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Objective: Half of all newly diagnosed patients with glioblastoma are older than 65 years and this number is expected to increase due to the aging population. The prognosis in the elderly remains poor. Preserving quality of life is of high importance. However, patient reported outcome (PRO) data in this patient group are rare. The aim was to analyze PROs and to compare an elderly cohort of high-grade glioma patients (HGG) with the younger subpopulation.
Methods: PRO assessment results of patients ≥65yrs with high-grade glioma (GBM/AA°III) were obtained during the ERASMUS study using the Distress Thermometer (DT), European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30), and the brain cancer specific module (BN20). Score of DT and subscales of EORTC instruments in patients ≥65y were compared to those <65y. Mann-Whitney-U-test was used to compare demographic data. Binary and linear multivariate regression models were used to assess influence on the above mentioned PRO measures were used as independent variables (age ≥65y, KPS ≥70, sex and time since diagnosis to assessment).
Results: N=93 (30%) out of n=309 patients were ≥65y (mean=70y, range 65-86y). The majority harbored a GBM (n=77, 83%), n=53 (57%) were male, median KPS was 70 (range 40-100). The younger population had a mean age of 48y (range 19-64), n=126 were male (57%), less patients had a GBM (n=103, 47%) and the median KPS was 80 (range 40-100). In explorative analyses we found significantly lower physical (physf) and emotional functioning (emof) (median elderly vs. younger: physf 60 vs. 86.7, p=.001; emof: 58.3. vs. 66.7, p=0.04). In a multi-regression analyses however, KPS≥/<70 revealed to be the only independent variable significantly influencing DT (ß -.39, p<.0001, 95%CI 3.2 -1.6) but also nearly all subscales of the EORTC instrument, e.g. physf (ß=.53, p<.0001, 95% CI 30.7-47.3).
Conclusion: We found our PRO results to be more associated with KPS than with calendaric age. This shows that within the context of recently developed treatment regimen for elderly patients, calendaric age should not be a sole factor in decision making. Rather biological age and functioning status should play a greater role to maintain high quality of life in this patient population.
