Glioblastoma multiforme in the very elderly

Connon, Felicity V; Rosenthal, Mark; Drummond, Kate

doi:10.1007/s10143-015-0652-0

Cited by 17 publications

(9 citation statements)

References 19 publications

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“…Moreover, the tolerability of combined radiotherapy and temozolomide seems to be reduced in the elderly [20]. However, other studies have shown that age in itself is not a contraindication to chemotherapy and recent trials for glioblastoma in the elderly have not included a combined radiation and chemotherapy arm [2]. MGMT promoter methyl ation was shown to be a prognostic marker of outcome, and a strong predictor of benefit with temozolomide chemotherapy in elderly patients [4,11,19,21,22].…”

Section: Research Article Pretanvil Salinas and Piccionimentioning

confidence: 99%

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Glioblastoma in the elderly: treatment patterns and survival

2016

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Section: Research Article Pretanvil Salinas and Piccionimentioning

confidence: 99%

“…Glioblastoma is the most common adult primary malignant brain tumor [1]. The median age at diagnosis is 64 years with a peak incidence in patients aged 75-84 years, numbers which are expected to further increase as the aging population expands [2,3]. Gliomas account for half of all intrinsic brain tumors.…”

Section: Introductionmentioning

confidence: 99%

Glioblastoma in the elderly: treatment patterns and survival

2016

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“…Prior studies in neurosurgical patients have used functional status (Karnofsky Performance Status [KPS] < 70) or age (≥ 85 years) to define frailty. 11,49 In the present study, all patients had a KPS of 100 except for 2 patients younger than 80 years with a KPS of 90. Frailty was quantified using the Canadian Study of Health and Aging Modified Frailty Index (mFI).…”

Section: Patientsmentioning

confidence: 44%

Validation of effectiveness of keyhole clipping in nonfrail elderly patients with unruptured intracranial aneurysms

Mori

Wada

Otani

et al. 2017

Journal of Neurosurgery

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OBJECTIVE Advanced age is known to be associated with a poor prognosis after surgical clipping of unruptured intracranial aneurysms (UIAs). Keyhole clipping techniques have been introduced for less invasive treatment of UIAs. In this study, the authors compared the complications and clinical and radiological outcomes after keyhole clipping between nonfrail elderly patients (≥ 70 years) and nonelderly patients. METHODS Keyhole clipping (either supraorbital or pterional) was performed to treat 260 cases of relatively small (≤ 10 mm) anterior circulation UIAs. There were 62 cases in the nonfrail elderly group (mean age 72.9 ± 2.6 years [± SD]) and 198 cases in the nonelderly group (mean age 59.5 ± 7.6 years). The authors evaluated mortality and morbidity (modified Rankin Scale score > 2 or Mini-Mental State Examination [MMSE] score < 24) at 3 months and 1 year after the operation, the general cognitive function by MMSE at 3 months and 1 year, anxiety and depression by the Beck Depression Inventory (BDI) and Hamilton Rating Scale for Depression (HAM-D) at 3 months, and radiological abnormalities and recurrence at 1 year. RESULTS Basic characteristics including comorbidities, frailty, and BDI and HAM-D scores were not significantly different between the 2 groups, whereas the MMSE score was slightly but significantly lower in the elderly group. Aneurysm location, largest diameter, type of keyhole surgery, neck clipping rate, and hospitalization period were not significantly different between the 2 groups. The incidence of chronic subdural hematoma was not significantly higher in the elderly group than in the nonelderly group (8.1% vs 4.5%, p = 0.332); rates of other complications including stroke and epilepsy were not significantly different. Lacunar infarction occurred in 3.2% of the elderly group and 3.0% of the nonelderly group. No patient in the elderly group required re-treatment or demonstrated recurrence of clipped aneurysms. The MMSE score at 3 months significantly improved in the nonelderly group but did not change in the elderly group. The BDI and HAM-D scores at 3 months were significantly improved in both groups. No patient died in either group. The morbidity at 3 months and 1 year in the elderly group (1.6% and 4.8%, respectively) was not significantly different from that in the nonelderly group (2.0% and 1.5%, respectively). CONCLUSIONS Keyhole clipping for nonfrail elderly patients with relatively small anterior circulation UIAs did not significantly increase the complication, mortality, or morbidity rate; hospitalization period; or aneurysm recurrence compared with nonelderly patients, and it was associated with improvement in anxiety and depression. Keyhole clipping to treat UIAs in the nonfrail elderly is an effective and long-lasting treatment.

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“…This is probably the reason why up to 34% of patients do not receive oncological treatment after diagnostic biopsy [19,22]. An even higher number was reported in an Australian study of GBM in patients aged 80 or older, where only 6 out of 40 patients continued with postoperative radiotherapy or chemotherapy [27].…”

Section: Discussionmentioning

confidence: 99%

Patterns of care and clinical outcome in assumed glioblastoma without tissue diagnosis: A population-based study of 131 consecutive patients

et al. 2020

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Background Elderly patients with glioblastoma and an accumulation of negative prognostic factors have an extremely short survival. There is no consensus on the clinical management of these patients and many may escape histologically verified diagnosis. The primary aim of this study was to characterize this particular subgroup of patients with radiological glioblastoma diagnosis without histological verification. The secondary aim was to evaluate if oncological therapy was of benefit. Methods Between November 2012 and June 2016, all consecutive patients presenting with a suspected glioblastoma in the western region of Sweden were registered in a population-based study. Of the 378 patients, 131 (35%) met the inclusion criteria of the present study by typical radiological features of glioblastoma without histological verification. Results The clinical characteristics of the 131 patients (72 men, 59 women) were: age � 75 (n = 99, 76%), performance status according to Eastern Cooperative Oncology Group � 2 (n = 93, 71%), significant comorbidity (n = 65, 50%) and multilobular tumors (n = 90, 69%). The overall median survival rate was 3.6 months. A subgroup of 44 patients (34%) received upfront treatment with temozolomide, with an overall radiological response rate of 34% and a median survival of 6.8 months, compared to 2.7 months for those receiving best supportive

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Glioblastoma multiforme in the very elderly

Cited by 17 publications

References 19 publications

Glioblastoma in the elderly: treatment patterns and survival

Glioblastoma in the elderly: treatment patterns and survival

Validation of effectiveness of keyhole clipping in nonfrail elderly patients with unruptured intracranial aneurysms

Patterns of care and clinical outcome in assumed glioblastoma without tissue diagnosis: A population-based study of 131 consecutive patients

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