Application analysis of surgical resection in elderly patients with glioblastoma
Li Liling
Ji Yuchen
Duan Wenchao
Liu Xianzhi
Abstract：Objective To investigate the surgical treatment efficacy in elderly patients(≥65 years)with glioblastoma(GBM).Methods Clinical data of 486 GBM patients aged over 40 years were analyzed retrospectively.Patients were divided into two groups based on age at diagnosis:middle-aged group(40-64 years,n=412)and elderly group(≥65 years,n=74).The surgical treatment options and survival outcomes were compared between the two groups.Results In the middle-aged group,139 patients underwent subtotal resection(STR),175 underwent gross total resection(GTR),and 47 underwent partial resection.In the elderly group,STR was performed in 21 patients,GTR in 22,and partial resection in 19.The elderly group had lower rates of GTR,radiotherapy,and chemotherapy application compared to the middle-aged group(P<0.05),while the partial resection rate was higher in the elderly group(P<0.05).The overall median survival period was 16(13,19)months in the middle-aged group and 9(7,15)months in the elderly group,with a statistically significant difference(P<0.05).Among patients who underwent craniotomy,the median survival period was 18(15,22)months in the middle-aged group and 10(8,18)months in the elderly group,also with a statistically significant difference(P<0.05).Age≥65 years,TP53 mutation,O6-methylguanine DNA methyltransferase(MGMT)promoter methylation,and Karnofsky performance status(KPS)<80 were risk factors(HR>1)affecting the 6-month survival rate of all GBM patients,while being married and undergoing GTR,radiotherapy,and chemotherapy were protective factors(HR<1)(all P<0.05).For elderly GBM patients,the Charlson comorbidity index(CCI)≥3 and MGMT promoter methylation were risk factors(HR>1)affecting the 6-month survival rate,whereas right-sided tumor and undergoing GTR,radiotherapy,and chemotherapy were protective factors(HR<1)(all P<0.05).Conclusions Elderly GBM patients had a lower proportion of receiving GTR,chemotherapy,and radiotherapy.However,elderly GBM patients who underwent GTR,radiotherapy,and chemotherapy demonstrate a survival advantage.Compared with radiotherapy and chemotherapy,the survival benefit of GTR surgical resection is relatively smaller for elderly GBM patients.
Keywords：gliomaglioblastomaold ageoperation
Publication Date：2025-05-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 272-279 )