Authors: Lucy Gately Anna Collins Michael Murphy Anthony Dowling
Publish Date: 2016/07/12
Volume: 129, Issue: 3, Pages: 479-485
Abstract
Over half of glioblastoma GBM cases are diagnosed in patients older than 65 years Their median overall survival OS is 4–5 months compared with 12–14 months in patients younger than 70 years This retrospective audit aims to identify patterns of care and survival of patients diagnosed with GBM at a single institution in Melbourne Australia Consecutive histological diagnoses of adult primary GBM from January 2010 to December 2012 were retrospectively identified from medical records Demographic treatment and survival characteristics were recorded until death with followup to January 1st 2015 Survival was estimated by Kaplan–Meier method Planned subgroup analyses were conducted using multivariate Cox proportional hazards model to identify differences between elderly and younger cohorts as well as ECOG 165 patients were identified 36 aged ≥70 years Those ≥70 years had a poorer performance status ECOG 3–4 27 vs 10 p = 005 poorer median OS 26 vs 115 months p 001 and were less likely to receive adjuvant treatment no treatment 40 vs 16 p 001 compared with patients 70 years Age was not a significant predictor of poorer os HR 10 099–103 p 05 after adjusting for other clinical factors Significant predictors of poorer os were poor performance status p = 001 bilateral tumours p = 04 biopsy only p = 001 and no adjuvant treatment p 001 In patients diagnosed with GBM those older than 70 years often present with poor performance status are less likely to receive adjuvant treatment and have inferior os compared with younger patients Treatment recommendations should be based on performance status/fitness not age alone
Keywords: