Low-grade gliomas in older patients: long-term follow-up from Mayo Clinic.
Background: Low-grade gliomas (LGGs) are uncommon in older patients, and long-term clinical behavior and prognostic factors are not well defined in this group.Methods: The authors retrospectively searched their tumor registry for the records of adult patients (> or =18 years) diagnosed as having non...
| Publicado en: | Cancer (0008543X) Vol. 115; no. 17; pp. 3969 - 3979 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
9/1/2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105414524&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105414524 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0008543X 23I jtl: Cancer (0008543X) issn: 0008543X maglogo: Y pubinfo: dt: 9/1/2009 vid: 115 iid: 17 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105414524 105414524 NLM19536875 2010381428 10.1002/cncr.24444 NLM19536875 PMC2789453 105414524 ppf: 3969 ppct: 10 formats: tig: atl: Low-grade gliomas in older patients: long-term follow-up from Mayo Clinic. aug: au: Schomas DA Laack NN Brown PD Schomas, David A Laack, Nadia N Brown, Paul D affil: Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA sug: subj: Brain Neoplasms Therapy Glioma Therapy Aged Brain Neoplasms Mortality Brain Neoplasms Pathology Chemotherapy, Adjuvant Female Glioma Mortality Glioma Pathology Male Middle Age Prognosis Prospective Studies Radiotherapy, Adjuvant Recurrence Retrospective Design Survival Analysis Treatment Outcomes Human Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Background: Low-grade gliomas (LGGs) are uncommon in older patients, and long-term clinical behavior and prognostic factors are not well defined in this group.Methods: The authors retrospectively searched their tumor registry for the records of adult patients (> or =18 years) diagnosed as having nonpilocytic LGG between 1960 and 1992 at Mayo Clinic. The Kaplan-Meier method was used to estimate progression-free survival and overall survival (OS) in patients aged 55 years and older.Results: Of 314 patients initially identified, 32 were aged at least 55 years, with a median age at diagnosis of 61 years (range, 55-74 years). Median follow-up was 17.3 years for survivors. Operative pathologic diagnoses comprised astrocytoma (n = 22, 69%), mixed oligoastrocytoma (n = 7, 22%), and oligodendroglioma (n = 3, 9%). Gross total resection was achieved in 1 patient, radical subtotal resection in 1, and subtotal resection in 14; 16 patients had biopsy only. Postoperative radiotherapy or chemotherapy was given to 23 (72%) patients and 1 (3%) patient, respectively. Median OS was 2.7 years for all patients: 3 years with resection and 2.2 years with biopsy only (P = .58). The 5- and 10-year OS rates were 31% and 18%, respectively. Factors adversely affecting OS on univariate analysis were enhancement on computed tomography (P < .001) and supratentorial location (P = .03).Conclusions: This retrospective series of older patients suggests that intracranial LGG in this age group behaves aggressively. Pathologic sampling error failing to recognize higher-grade tumors does not seem to account for these poor outcomes. Aggressive management with maximally safe resection followed by adjuvant therapy should be strongly considered. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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