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Brain Metastases in Elderly Patients—The Role of Surgery in the Context of Systemic Treatment
In patients with brain metastases (BM), advanced age is considered a negative prognostic factor. To address the potential reasons for that, we assessed 807 patients who had undergone BM resection; 315 patients aged at least 65 years (group A) were compared with 492 younger patients (group B). We ana...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831306/ https://www.ncbi.nlm.nih.gov/pubmed/33477588 http://dx.doi.org/10.3390/brainsci11010123 |
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author | Proescholdt, Martin Jünger, Stephanie T. Schödel, Petra Schebesch, Karl-Michael Doenitz, Christian Pukrop, Tobias Höhne, Julius Schmidt, Nils-Ole Kocher, Martin Schulz, Holger Ruge, Maximilian König, Kevin Goldbrunner, Roland Grau, Stefan |
author_facet | Proescholdt, Martin Jünger, Stephanie T. Schödel, Petra Schebesch, Karl-Michael Doenitz, Christian Pukrop, Tobias Höhne, Julius Schmidt, Nils-Ole Kocher, Martin Schulz, Holger Ruge, Maximilian König, Kevin Goldbrunner, Roland Grau, Stefan |
author_sort | Proescholdt, Martin |
collection | PubMed |
description | In patients with brain metastases (BM), advanced age is considered a negative prognostic factor. To address the potential reasons for that, we assessed 807 patients who had undergone BM resection; 315 patients aged at least 65 years (group A) were compared with 492 younger patients (group B). We analyzed the impact of the pre- and postoperative Karnofsky performance status (KPS), postoperative treatment structure and post-treatment survival. BM resection significantly improved KPS scores in both groups (p = 0.0001). Median survival after BM resection differed significantly between the groups (A: 5.81 vs. B: 8.12 months; p = 0.0015). In both groups, patients who received postoperative systemic treatment showed significantly longer overall survival (p = 0.00001). However, elderly patients less frequently received systemic treatment (p = 0.0001) and the subgroup of elderly patients receiving such therapies had a significantly higher postsurgical KPS score (p = 0.0007). In all patients receiving systemic treatment, age was no longer a negative prognostic factor. Resection of BM improves the functional status of elderly patients, thus enhancing the likeliness to receive systemic treatment, which, in turn, leads to longer overall survival. In the context of such a treatment structure, age alone is no longer a prognostic factor for survival. |
format | Online Article Text |
id | pubmed-7831306 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-78313062021-01-26 Brain Metastases in Elderly Patients—The Role of Surgery in the Context of Systemic Treatment Proescholdt, Martin Jünger, Stephanie T. Schödel, Petra Schebesch, Karl-Michael Doenitz, Christian Pukrop, Tobias Höhne, Julius Schmidt, Nils-Ole Kocher, Martin Schulz, Holger Ruge, Maximilian König, Kevin Goldbrunner, Roland Grau, Stefan Brain Sci Article In patients with brain metastases (BM), advanced age is considered a negative prognostic factor. To address the potential reasons for that, we assessed 807 patients who had undergone BM resection; 315 patients aged at least 65 years (group A) were compared with 492 younger patients (group B). We analyzed the impact of the pre- and postoperative Karnofsky performance status (KPS), postoperative treatment structure and post-treatment survival. BM resection significantly improved KPS scores in both groups (p = 0.0001). Median survival after BM resection differed significantly between the groups (A: 5.81 vs. B: 8.12 months; p = 0.0015). In both groups, patients who received postoperative systemic treatment showed significantly longer overall survival (p = 0.00001). However, elderly patients less frequently received systemic treatment (p = 0.0001) and the subgroup of elderly patients receiving such therapies had a significantly higher postsurgical KPS score (p = 0.0007). In all patients receiving systemic treatment, age was no longer a negative prognostic factor. Resection of BM improves the functional status of elderly patients, thus enhancing the likeliness to receive systemic treatment, which, in turn, leads to longer overall survival. In the context of such a treatment structure, age alone is no longer a prognostic factor for survival. MDPI 2021-01-18 /pmc/articles/PMC7831306/ /pubmed/33477588 http://dx.doi.org/10.3390/brainsci11010123 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Proescholdt, Martin Jünger, Stephanie T. Schödel, Petra Schebesch, Karl-Michael Doenitz, Christian Pukrop, Tobias Höhne, Julius Schmidt, Nils-Ole Kocher, Martin Schulz, Holger Ruge, Maximilian König, Kevin Goldbrunner, Roland Grau, Stefan Brain Metastases in Elderly Patients—The Role of Surgery in the Context of Systemic Treatment |
title | Brain Metastases in Elderly Patients—The Role of Surgery in the Context of Systemic Treatment |
title_full | Brain Metastases in Elderly Patients—The Role of Surgery in the Context of Systemic Treatment |
title_fullStr | Brain Metastases in Elderly Patients—The Role of Surgery in the Context of Systemic Treatment |
title_full_unstemmed | Brain Metastases in Elderly Patients—The Role of Surgery in the Context of Systemic Treatment |
title_short | Brain Metastases in Elderly Patients—The Role of Surgery in the Context of Systemic Treatment |
title_sort | brain metastases in elderly patients—the role of surgery in the context of systemic treatment |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831306/ https://www.ncbi.nlm.nih.gov/pubmed/33477588 http://dx.doi.org/10.3390/brainsci11010123 |
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