Low-grade gliomas in older patients: long-term follow-up from Mayo Clinic.

Full Abstract

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.

Author information

Author/s: Schomas, David A (DA); Laack, Nadia N (NN); Brown, Paul D (PD);

Affiliation: Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA.

Grants: 1 UL1 RR024150-01 (Agency:NCRR NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural

Journal: Cancer (Cancer), published in United States. (Language: eng)

Reference: 2009-Sep; vol 115 (issue 17) : pp 3969-78

Dates: Created 2009/08/26; Completed 2009/10/01;

PMID: 19536875, status: MEDLINE (last retrieval date: 10/1/2009, IMS Date: )

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