Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival
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Published:2020-09
Issue:3
Volume:149
Page:421-427
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ISSN:0167-594X
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Container-title:Journal of Neuro-Oncology
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language:en
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Short-container-title:J Neurooncol
Author:
Schneider MatthiasORCID, Potthoff Anna-Laura, Scharnböck Elisa, Heimann Muriel, Schäfer Niklas, Weller Johannes, Schaub Christina, Jacobs Andreas H., Güresir Erdem, Herrlinger Ulrich, Vatter Hartmut, Schuss Patrick
Abstract
Abstract
Object
Increasing age is a known negative prognostic factor for glioblastoma. However, a multifactorial approach is necessary to achieve optimal neuro-oncological treatment. It remains unclear to what extent frailty, comorbidity burden, and obesity might exert influence on survival in geriatric glioblastoma patients. We have therefore reviewed our institutional database to assess the prognostic value of these factors in elderly glioblastoma patients.
Methods
Between 2012 and 2018, patients aged ≥ 65 years with newly diagnosed glioblastoma were included in this retrospective analysis. Patients frailty was analyzed using the modified frailty index (mFI), while patients comorbidity burden was assessed according to the Charlson comorbidity index (CCI). Body mass index (BMI) was used as categorized variable.
Results
A total of 110 geriatric patients with newly diagnosed glioblastoma were identified. Geriatric patients categorized as least-frail achieved a median overall survival (mOS) of 17 months, whereas most frail patients achieved a mOS of 8 months (p = 0.003). Patients with a CCI > 2 had a lower mOS of 6 months compared to patients with a lower comorbidity burden (12 months; p = 0.03). Multivariate analysis identified “subtotal resection” (p = 0.02), “unmethylated MGMT promoter status” (p = 0.03), “BMI < 30” (p = 0.04), and “frail patient (mFI ≥ 0.27)” (p = 0.03) as significant and independent predictors of 1-year mortality in geriatric patients with surgical treatment of glioblastoma (Nagelkerke's R2 0.31).
Conclusions
The present study concludes that both increased frailty and comorbidity burden are significantly associated with poor OS in geriatric patients with glioblastoma. Further, the present series suggests an obesity paradox in geriatric glioblastoma patients.
Funder
Universitätsklinikum Bonn
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Clinical Neurology,Neurology,Oncology
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