title: Surgery for high-grade gliomas in the aging.
abstract: OBJECTIVE
  High-grade glioma (HGG) is the commonest primary brain tumor in adults. We prospectively assessed outcome following surgery and adjuvant treatment for HGG in older patients.
  
  
  METHODS
  Patients ≥ 60 years undergoing craniotomies for gliomas WHO grade 3 and 4 at Oslo and Haukeland University Hospitals 2008-2009 were included (n = 80). Outcome was assessed at six months, and overall mortality evaluated at two years.
  
  
  RESULTS
  Forty-two males and 38 females of median age 68.5 (60-83) years were included, 35% attended a follow-up appointment at six months. Surgical mortality was 1.3%. Surgical morbidity included neurological sequela (10%), post-operative hematomas (3.8%) and hydrocephalus (1.3%). Median overall survival was 8.4 months and significantly increased by adjuvant radiochemotherapy. In univariate survival analyses, age ≥ 80 years, subtotal resection, American Society of Anesthesiology (ASA) scores 3-4, Karnofsky performance scale (KPS) < 70, and mini-mental state examination (MMSE) score < 25 significantly reduced survival.
  
  
  CONCLUSIONS
  Surgical treatment of HGG carries low mortality and acceptable morbidity in patients aged ≥ 60 years. There is improved survival following bimodal adjuvant treatment. Maximum tumor resection should be attempted. Treatment might be less beneficial in patients aged ≥ 80 years and in those with poor pre-operative function.
authors: Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
authors: A
authors: A
authors: Konglund
authors: R
authors: R
authors: Helseth
authors: M
authors: M
authors: Lund-Johansen
authors: E
authors: E
authors: Helseth
authors: T R
authors: TR
authors: Meling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D005260:Female; D005910:Glioma / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D006406:Hematoma / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D016016:Proportional Hazards Models; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Neurooncology; Quality of life