The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.
Key Takeaway
Gross total resection is an independent predictor of longer survival and good postoperative functional recovery in patients with isocitrate dehydrogenase (IDH)–wildtype glioblastoma, regardless of baseline frailty scores.
Why This Matters
The management of frail, elderly patients with an IDH-wildtype glioblastoma is controversial, and there is no standardized therapeutic approach.
The team found that gross total resection is feasible and that complication rates are low, even in frail patients.
The results build a case for aggressive resection in older, frail patients.
Study Design
The team reviewed records of 47 patients aged 65 years or older with IDH-wildtype glioblastoma. The researchers correlated surgical outcomes with baseline variables, including scores on the five-item modified frailty index (5-mFI).
The frailty score was calculated by assigning a point to the following comorbidities: functional dependent status, history of diabetes mellitus, hypertension, chronic obstructive pulmonary disease or pneumonia, and congestive heart failure.
Surgical approach was left to the neurosurgeon's discretion.
The mean age of the patients was 73 years; two thirds were men.
Key Results
A gross total resection was performed in 26 patients (55.3%), a subtotal resection in 13 patients (27.6%), and a biopsy in eight patients (17.1%).
