Evaluation of frailty, cognitive function, and age as prognostic factors for survival in patients with IDH1wild-type high-grade glioma

Abstract

Abstract INTRODUCTION: High-grade gliomas without isocitrate dehydrogenase (IDH) mutations are associated with poor survival and have been poorly studied. Our aim was to investigate the prognostic factors for survival in this group, focusing on frailty, age, and cognition. METHODS: This study included Slovenian patients with high-grade IDH1 wild-type gliomas. Frailty and cognitive functioning were measured postoperatively using the Clinical Frailty Scale and neuropsychological test battery. Descriptive statistics were used to analyze the demographic and clinical data. Univariate and multivariate Cox proportional hazard regression models were used to examine the clinical predictors and prognostic value of the cognitive test scores. Kaplan-Meier curves were generated, and the log-rank test was used. RESULTS: Data from 75 patients were analyzed. The median time to progression was 11.0 months, and the median survival was 12.8 months. Multivariate analysis revealed that frailty, sex, O6-methylguanine-DNA methyltransferase methylation, and verbal fluency, but not the global cognitive functioning, were significant prognostic factors for survival. Age was a statistically significant prognostic factor in the univariate regression model; when other factors were controlled for in the multivariate model, age lost its prognostic value. CONCLUSION: Frailty is an important prognostic factor for survival of patients with high-grade IDH1 wild-type gliomas. Cognitive functioning in the domain of verbal fluency remained an independent prognostic factor for survival after controlling for other factors.