Prognosis and patterns of care in elderly patients with glioma.
BACKGROUND
The current study was conducted to evaluate the patterns of care and survival of older adults with oligodendroglioma (OLI) and astrocytoma (AST) from a large population-based registry.


METHODS
The authors identified a cohort of OLI and AST patients aged >or=65 years from Surveillance, Epidemiology and End Results (SEER) cancer registry data linked with Medicare claims between 1994 and 2002. Patients with a diagnosis of glioblastoma were excluded. The impact of demographic characteristics and comorbidities on the probability of undergoing surgical resection, radiotherapy (RT), and chemotherapy within 6 months of diagnosis was assessed using multivariate logistic regression.


RESULTS
A total of 1067 patients (891 with AST and 176 with OLI) were included; the median survival was 9 months for patients with low-grade AST, 4 months for patients with anaplastic AST, 57 months for patients with low-grade OLI, and 9 months for patients with anaplastic OLI. Approximately 54% of patients underwent resection at the time of diagnosis; 66% received RT, and 13% received chemotherapy within 6 months of diagnosis. In a multivariate regression analysis, age and tumor grade were found to be the most significant predictors of resection, RT, or chemotherapy. Patients with anaplastic tumors were treated with resection, RT, and chemotherapy more often than patients with low-grade tumors, and OLI patients received chemotherapy more frequently than AST.


CONCLUSIONS
Data from the current study suggested that histologic diagnosis and tumor grade retained significant prognostic value in this elderly AST and OLI population. Furthermore, age and tumor grade were found to influence the probability of undergoing surgery, RT, and chemotherapy in this cohort.
Iwamoto
Fabio M
FM
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
Reiner
Anne S
AS
Nayak
Lakshmi
L
Panageas
Katherine S
KS
Elkin
Elena B
EB
Abrey
Lauren E
LE
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001254:Astrocytoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D005910:Glioma / Q000628:therapy; D006801:Humans; D008297:Male; D009837:Oligodendroglioma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D016019:Survival Analysis
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