Impact of resection on overall survival of recurrent Glioblastoma in elderly it patients
Impact of resection on overall survival of recurrent Glioblastoma in elderly it patients
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DOI：
10.1016/j.clineuro.2018.08.033
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发表时间：
2018-11-01
影响因子：
1.9
通讯作者：
Quick-Weller, Johanna
中科院分区：
文献类型：
--
作者：
Hager, Jasmin;Herrmann, Eva;Quick-Weller, Johanna
目的：多形性胶质母细胞瘤（GBM）多见于老年患者。适当的治疗，特别是在肿瘤复发的情况下，仍在讨论中，因为大多数研究集中在65岁以下的患者。我们评估了第二次手术的影响，无进展生存期（PFS）和总生存期（OAS）在老年patients.Patients和方法：59例复发性多形性胶质母细胞瘤进行了回顾性评价。患者被分为三个亚组：立体定向活检（STX），切除和第二次切除。第二组和第三组在首次诊断后合并为“手术”。所有组的中位年龄为71岁，主要终点是总生存率。统计分析计算使用Kaplan-Meier分析和SPSS.Results：OAS是显着较长的患者接受手术相比，STX组。对于接受再切除术的患者，OAS并没有显著延长。年龄（71岁以上）对OAS无显著影响。与接受STX的患者相比，接受手术的患者的PFS显著增加。接受第二次切除术的患者的PFS没有显著延长。71岁以下及以上患者的PFS无显著差异。结论：与单纯STX相比，接受手术的患者的OAS和PFS显著增加。术后生存期延长近4个月（p > 0.05）。老年GBM患者的治疗仍然是个人决定，优先考虑生活质量。应考虑临床状况、合并症和家庭背景）。
Objectives: Glioblastoma multiforme (GBM) mostly affects elderly patients. Adequate therapy especially in case of tumor recurrence is still under discussion, since most studies focus on patients under 65 years. We evaluated the impact of second surgery in regard to progression free survival (PFS) and overall survival (OAS) in elderly patients.Patients and methods: 59 patients with recurrent glioblastoma multiforme were retrospectively evaluated. Patients were divided into three subgroups: stereotactic biopsy (STX), resection and second resection. Second and third group were pooled as "surgery' after first diagnosis. The median age for all groups was 71 years.The primary endpoint was overall survival. Statistical analysis was calculated using Kaplan-Meier analysis and SPSS.Results: OAS was significantly longer for patients who had undergone surgery compared to the STX group. For patients who underwent reresection OAS was not significantly longer. Age (over 71) had no significant effect on OAS. PFS was significantly increased in patients who underwent surgery compared to those who underwent STX. PFS was not significantly longer in patients who underwent second resection. Furthermore PFS was not significantly different between patients under 71 and over.Conclusion: OAS and PFS were significant increased for patients who underwent surgery compared to only STX. Patients showed prolonged survival of almost 4 months after they underwent reresection (p > 0.05). Therapy of elderly patients with GBM remains an individual decision with priority on quality of life. Clinical status, comorbidities and family background) should be taken into account.