Supratentorial low-grade gliomas in older patients.
BACKGROUND
Low-grade gliomas (LGG) are thought to be very rare in elderly patients (>60 years) and have not been thoroughly studied.


METHODS
A series of 62 elderly (>or=60 years of age) LGG patients were identified in a department database collecting information on pathologically identified adult supratentorial LGG. The clinical, radiologic, pathologic, and therapeutic data of these patients were analyzed and compared to those of 704 younger LGG patients (<60 years).


RESULTS
Comparisons between older and younger groups showed that elderly patients more often presented with a clinical deficit (p < 0.0001), a lower Karnofsky performance status (p = 0.0002), a larger tumor on MRI (p = 0.03), and a lower rate of tumor resection (p < 0.0001). Chemotherapy was more often used as first line treatment (p = 0.001). Among the patients who died of progressive disease, 55% of the elderly patients had not received radiotherapy compared to 11% in the younger group (p < 0.0001). Survival was shorter in older patients (p < 0.0001), with a 5-year survival rate of 40%. An astrocytic phenotype (p = 0.0097), increasing age (p = 0.0049), and a tumor crossing the midline (p = 0.028) were negative prognostic factors in the older group.


CONCLUSIONS
We found that 8% of low-grade gliomas (LGG) occur in older patients (>or=60 years of age). The clinical-radiologic picture of LGG in the elderly population differs from younger patients. Although long-term survival occurs, the course is generally more severe because elderly patients accumulate negative prognostic factors and because they are probably undertreated.
Kaloshi
G
G
AP-HP, Service de Neurologie Mazarin, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Psimaras
D
D
Mokhtari
K
K
Dehais
C
C
Houillier
C
C
Marie
Y
Y
Laigle-Donadey
F
F
Taillibert
S
S
Guillevin
R
R
Martin-Duverneuil
N
N
Sanson
M
M
Hoang-Xuan
K
K
Delattre
J-Y
JY
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004358:Drug Therapy / Q000706:statistics & numerical data; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D011379:Prognosis; D011878:Radiotherapy / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D015173:Supratentorial Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D015996:Survival Rate; D055815:Young Adult