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.
Keywords: Elderly patients; Glioblastoma; Recurrent glioblastoma; Reresection; Resection; Survival; Tumor recurrence.
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