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Geriatric Grade 2 and 3 Gliomas: A National Cancer Database Analysis of Demographics, Treatment Utilization, and Survival Publisher Pubmed



Karabacak M1 ; Jazayeri SB2 ; Jagtiani P3 ; Mavridis O4 ; Carrasquilla A1 ; Yong RL1 ; Margetis K1
Authors
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Authors Affiliations
  1. 1. Department of Neurosurgery, Mount Sinai Health System, New York, NY, United States
  2. 2. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. School of Medicine, SUNY Downstate Health Sciences University, New York, NY, United States
  4. 4. Dietrich College of Humanities and Social Sciences, Carnegie Mellon University, Pittsburgh, PA, United States

Source: Journal of Clinical Neuroscience Published:2024


Abstract

With increasing life expectancies and population aging, the incidence of elderly patients with grade 2 and 3 gliomas is increasing. However, there is a paucity of knowledge on factors affecting their treatment selection and overall survival (OS). Geriatric patients aged between 60 and 89 years with histologically proven grade 2 and 3 intracranial gliomas were identified from the National Cancer Database between 2010 and 2017. We analyzed patients’ demographic data, tumor characteristics, treatment modality, and outcomes. The Kaplan-Meier method was used to analyze OS. Univariate and multivariate analyses were performed to assess the predictive factors of mortality and treatment selection. A total of 6257 patients were identified: 3533 (56.3 %) hexagenerians, 2063 (32.9 %) septuagenarians, and 679 (10.8 %) octogenarians. We identified predictors of lower OS in patients, including demographic factors (older age, non-zero Charlson-Deyo score, non-Hispanic ethnicity), socioeconomic factors (low income, treatment at non-academic centers, government insurance), and tumor-specific factors (higher grade, astrocytoma histology, multifocality). Receiving surgery and chemotherapy were associated with a lower risk of mortality, whereas receiving radiotherapy was not associated with better OS. Our findings provide valuable insights into the complex interplay of demographic, socioeconomic, and tumor-specific factors that influence treatment selection and OS in geriatric grade 2 and 3 gliomas. We found that advancing age correlates with a decrease in OS and a reduced likelihood of undergoing surgery, chemotherapy, or radiotherapy. While receiving surgery and chemotherapy were associated with improved OS, radiotherapy did not exhibit a similar association. © 2024