Abstract
Background: The optimal strategy for the management of high-grade glioma in the elderly (≥60.0 years) remains controversial, especially regarding the effects of surgical extent on survival outcomes. The purpose of this study was to compare gross total resection (GTR) with subtotal resection (STR) for treatment effects in elderly patients with high-grade glioma.Methods: Three electronic databases were systematically searched, including PubMed, EmBase, and the Cochrane library, from inception to August 2018. Hazard ratios (HRs) or odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to express summary effect estimates using the random-effects model. Nineteen retrospective observational studies involving a total of 10,815 elderly patients with high-grade glioma were included in this meta-analysis.Results: The summary results indicated that GTR was associated with a significant improvement in overall survival (OS) compared with STR (HR = 0.70, 95% CI = 0.64–0.77). In addition, elderly patients administered GTR showed lower risk of 3-month mortality (OR = 0.47, 95% CI = 0.24–0.93), 6-month mortality (OR = 0.38, 95% CI = 0.26–0.56), 9-month mortality (OR = 0.35, 95% CI = 0.25–0.49), and 1-year mortality (OR = 0.40, 95% CI = 0.29–0.56). Pooled OS data differed when stratified by publication year, country, sample size, disease status, and study quality.Conclusion: GTR seems to be more effective than STR in achieving longer survival in elderly patients with high-grade glioma.
Highlights
Glioblastoma multiforme (GBM) is the most frequent malignancy of the central nervous system, with an incidence of approximately 4.8/100,000 cases annually [1, 2]
The summary results indicated that Gross total resection (GTR) was associated with a significant improvement in overall survival (OS) compared with subtotal resection (STR) (HR = 0.70, 95% confidence intervals (CIs) = 0.64–0.77)
GTR seems to be more effective than STR in achieving longer survival in elderly patients with high-grade glioma
Summary
Glioblastoma multiforme (GBM) is the most frequent malignancy of the central nervous system, with an incidence of approximately 4.8/100,000 cases annually [1, 2]. The value of surgical extent in elderly patients with high-grade glioma remains unestablished. A previous meta-analysis based on 37 studies assessed whether greater extent of surgery affects survival outcomes in GBM patients and found that GTR is associated with significantly improved overall survival (OS) and progression-free survival (PFS) compared with subtotal resection (STR) [13]. GTR and STR have not been comparatively assessed for their effects in elderly patients with high-grade glioma. The optimal strategy for the management of high-grade glioma in the elderly (≥60.0 years) remains controversial, especially regarding the effects of surgical extent on survival outcomes. The purpose of this study was to compare gross total resection (GTR) with subtotal resection (STR) for treatment effects in elderly patients with high-grade glioma
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
