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Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival
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 gli...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7609438/ https://www.ncbi.nlm.nih.gov/pubmed/32989681 http://dx.doi.org/10.1007/s11060-020-03625-2 |
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author | Schneider, Matthias Potthoff, Anna-Laura Scharnböck, Elisa Heimann, Muriel Schäfer, Niklas Weller, Johannes Schaub, Christina Jacobs, Andreas H. Güresir, Erdem Herrlinger, Ulrich Vatter, Hartmut Schuss, Patrick |
author_facet | Schneider, Matthias Potthoff, Anna-Laura Scharnböck, Elisa Heimann, Muriel Schäfer, Niklas Weller, Johannes Schaub, Christina Jacobs, Andreas H. Güresir, Erdem Herrlinger, Ulrich Vatter, Hartmut Schuss, Patrick |
author_sort | Schneider, Matthias |
collection | PubMed |
description | 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 R(2) 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11060-020-03625-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7609438 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-76094382020-11-10 Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival Schneider, Matthias Potthoff, Anna-Laura Scharnböck, Elisa Heimann, Muriel Schäfer, Niklas Weller, Johannes Schaub, Christina Jacobs, Andreas H. Güresir, Erdem Herrlinger, Ulrich Vatter, Hartmut Schuss, Patrick J Neurooncol Clinical Study 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 R(2) 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11060-020-03625-2) contains supplementary material, which is available to authorized users. Springer US 2020-09-29 2020 /pmc/articles/PMC7609438/ /pubmed/32989681 http://dx.doi.org/10.1007/s11060-020-03625-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Clinical Study Schneider, Matthias Potthoff, Anna-Laura Scharnböck, Elisa Heimann, Muriel Schäfer, Niklas Weller, Johannes Schaub, Christina Jacobs, Andreas H. Güresir, Erdem Herrlinger, Ulrich Vatter, Hartmut Schuss, Patrick Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival |
title | Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival |
title_full | Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival |
title_fullStr | Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival |
title_full_unstemmed | Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival |
title_short | Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival |
title_sort | newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7609438/ https://www.ncbi.nlm.nih.gov/pubmed/32989681 http://dx.doi.org/10.1007/s11060-020-03625-2 |
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