Gross-total resection of malignant gliomas in elderly patients: implications in survival.

Zentralblatt Fur Neurochirurgie Pub Date : 2007-11-01 Epub Date: 2007-10-26 DOI:10.1055/s-2007-985851
R Martinez, M Janka, F Soldner, R Behr
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引用次数: 17

Abstract

Background: Malignant gliomas in elderly patients are frequently under represented in neuro-oncology trials because of presumed low tolerability of gross-total resection and radiochemotherapy treatments. Thus, the balance of benefit versus adverse response of standard glioma therapy remains controversial. We hypothesized that older patients with malignant gliomas might also take advantage of extensive surgical procedures.

Patients and methods: We analyzed retrospectively 138 consecutive malignant glioma patients. Sixty-two patients were >65 years whereas seventy-six were

Results: At diagnosis, elderly patients showed a larger burden of comorbidities but they did not influence outcome significantly. Gross-total resection was associated with a longer survival as compared to biopsy and subtotal resection in both groups of elderly (P=0.05 and 0.001, respectively) and younger patients (P=0.004 and 0.003). Concerning complications, the only difference between both collectives was a higher incidence of psychosyndrome in the elderly group (P=0.016).

Conclusions: Our results indicate that gross-total resection of malignant gliomas in elderly patients is associated with a survival benefit without increased morbidity.

老年患者恶性胶质瘤的全切除:对生存的影响。
背景:老年患者的恶性胶质瘤在神经肿瘤学试验中经常被低估,因为他们被认为对全切除和放化疗的耐受性较低。因此,标准胶质瘤治疗的获益与不良反应的平衡仍然存在争议。我们假设老年恶性胶质瘤患者也可能利用广泛的外科手术。患者和方法:我们回顾性分析了138例恶性胶质瘤患者。结果:在诊断时,老年患者表现出更大的合并症负担,但它们对预后没有显著影响。与活检和次全切除术相比,两组老年人(P=0.05和0.001)和年轻患者(P=0.004和0.003)的总全切除术与更长的生存期相关。在并发症方面,两组之间唯一的差异是老年组的精神综合征发生率较高(P=0.016)。结论:我们的研究结果表明,老年患者恶性胶质瘤的总切除与生存获益相关,而不增加发病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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Zentralblatt Fur Neurochirurgie
Zentralblatt Fur Neurochirurgie 医学-神经科学
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