NCOG-17. PREDICTORS OF SURVIVAL IN ELDERLY PATIENTS UNDERGOING SURGERY FOR GBM

Abstract

Abstract BACKGROUND Despite the median age of diagnosis of GBM being 64 years old, there is only a paucity of studies on elderly patients with GBM. Furthermore, the majority of these studies examine treatment paradigms, and there is limited research on clinical and hospital factors on overall survival. The purpose of this study is to determine predictors of survival in elderly patients undergoing surgery for GBM. METHODS We searched our hospital brain tumour biobank database for all consecutive patients over a 14-year period from 2005 to 2018. All patients 65 years of age or older at time of surgery with a pathological diagnosis of de novo primary GBM were included. Kaplan-Meier survival curve and Cox proportional hazards model were constructed for overall survival vs age, sex, KPS, medical co-morbidities, extent of resection by surgeon, length of stay, postop complications, and discharge destination. RESULTS A total of 150 patients were included. The median age at time of surgery was 74 years old (range: 65-94). Median overall survival was 9.4 months (95% CI: 7.8-12.2). Variables associated with worse survival included longer length of stay (HR: 1.15, 95% CI: 1.02-1.30, p = 0.02), discharge destination other than home (HR: 1.91, 95% CI: 1.01-3.6, p = 0.04), and any postop complication (HR: 3.7, 95% CI: 1.87-7.3, p = < 0.001). The presence of any or multiple medical comorbidities was not associated with worse survival (p = 0.93 and 0.19, respectively). CONCLUSIONS The presence of medical comorbidities is not associated with worse survival in elderly patients undergoing surgery for GBM. In order to maximize survival in these patients, avoidance of postoperative complications is paramount, along with a short hospital stay and attempt to discharge these patients to their home.