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Open Access 01-09-2020 | Glioblastoma | Clinical Study

Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival

Authors: Matthias Schneider, Anna-Laura Potthoff, Elisa Scharnböck, Muriel Heimann, Niklas Schäfer, Johannes Weller, Christina Schaub, Andreas H. Jacobs, Erdem Güresir, Ulrich Herrlinger, Hartmut Vatter, Patrick Schuss

Published in: Journal of Neuro-Oncology | Issue 3/2020

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.

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Title: Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival
Authors: Matthias Schneider
Anna-Laura Potthoff
Elisa Scharnböck
Muriel Heimann
Niklas Schäfer
Johannes Weller
Christina Schaub
Andreas H. Jacobs
Erdem Güresir
Ulrich Herrlinger
Hartmut Vatter
Patrick Schuss
Publication date: 01-09-2020
Publisher: Springer US
Keywords: Glioblastoma
Obesity
Obesity
Glioblastoma
Glioblastoma
Published in: Journal of Neuro-Oncology / Issue 3/2020
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-020-03625-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Newly diagnosed glioblastoma in geriatric (65 +) patients: impact of patients frailty, comorbidity burden and obesity on overall survival

Abstract

Object

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Object

Methods

Results

Conclusions

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