title: Prognostic factors in elderly patients with supratentorial malignant gliomas.
abstract: The prognostic factors were retrospectively analyzed in 30 patients aged 70 years or over with supratentorial malignant gliomas treated by surgery in our hospital. The histological diagnosis was confirmed as grade 3 in 13 patients and grade 4 in 17. Seventeen patients received adjuvant radiation therapy. Only 10 patients underwent chemotherapy. Survival time was analyzed with the Kaplan-Meier method. Prognostic factors were obtained from the Cox proportional hazards model. Univariate analysis showed preoperative Karnofsky performance status (KPS) score of 70 or greater and radiation therapy were significantly associated with longer survival. However, multivariate analysis revealed that preoperative KPS score of 70 or greater was the only independent prognostic factor and radiation therapy lost its significance due to selection bias. Neurological deterioration and medical complications occurred in six and seven patients, respectively. Performance status rather than histological grade is the key prognostic factor in elderly patients with supratentorial malignant gliomas. Patients with good preoperative KPS score should be aggressively treated with extensive resection and radiotherapy.
authors.affiliation: Department of Neurosurgery, University of Toyama, Toyama, Japan. kuri3312@med.u-toyama.ac.jp
authors.forename: Masanori
authors.initials: M
authors.lastname: Kurimoto
authors.forename: Shoichi
authors.initials: S
authors.lastname: Nagai
authors.forename: Hironaga
authors.initials: H
authors.lastname: Kamiyama
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Tsuboi
authors.forename: Kunikazu
authors.initials: K
authors.lastname: Kurosaki
authors.forename: Nakamasa
authors.initials: N
authors.lastname: Hayashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.forename: Shunro
authors.initials: S
authors.lastname: Endo
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005910:Glioma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015173:Supratentorial Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome