Abstract
BACKGROUND: High Grade Gliomas (HGG, grade 3 or grade 4 gliomas) are common malignant primary brain tumors and a large number of cases occur in patients aged >65 years. However, there is limited data on specific prognostic factors and outcomes in this population. METHODS: After IRB approval, the Cleveland Clinic Brain Tumor and Neuro-Oncology Center's database was used to identify patients > 65 years of age with HGG diagnosed from 2007-2014 . Multivariate analysis was conducted using a Cox proportional hazards model and stepwise selection algorithm using p = .10 and p = .05 as criteria for entry and retention to identify independent predictors of survival from diagnosis. RESULTS: 193 patients were included in the analysis (61% male). Median age at diagnosis was 73 years (range 66-94). At presentation, 45% had Karnofsky performance status (KPS) > 80; 34% had KPS 75, p = .03), performance status (KPS >80 vs 70 vs 50-60 vs <50, p < .0001) and multifocal disease (no vs yes, p = .02) were independently associated with overall survival. CONCLUSIONS: Overall survival in elderly patients with HGG is dismal. Younger age, better performance status, and absence of multifocal disease were associated with improved survival.
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