Frailty in Glioblastoma Is Independent From Chronological Age

Objective: Treatment of glioblastoma in elderly patients is particularly challenging due to their general condition and comorbidities. Treatment decisions are often based on chronological age. Frailty screening tests promise an assessment tool to stratify geriatric patients and identify those at ris...

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Autores principales:	Harald Krenzlin, Dragan Jankovic, Christoph Alberter, Darius Kalasauskas, Christiane Westphalen, Florian Ringel, Naureen Keric
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	glioblastoma frailty Groningen Frailty Index G8 geriatric patients Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/16fdb8e62d64496a89ce3b736d630c5d
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spelling	oai:doaj.org-article:16fdb8e62d64496a89ce3b736d630c5d2021-12-01T18:38:24ZFrailty in Glioblastoma Is Independent From Chronological Age1664-229510.3389/fneur.2021.777120https://doaj.org/article/16fdb8e62d64496a89ce3b736d630c5d2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.777120/fullhttps://doaj.org/toc/1664-2295Objective: Treatment of glioblastoma in elderly patients is particularly challenging due to their general condition and comorbidities. Treatment decisions are often based on chronological age. Frailty screening tests promise an assessment tool to stratify geriatric patients and identify those at risk for an unfavorable outcome. This study aims to evaluate the impact of age and frailty on the surgical outcome and overall survival in geriatric patients with glioblastoma.Methods: Data acquisition was conducted as a single-center retrospective analysis. From January 1st 2015, and December 31st 2019, 104 glioblastoma patients over 70 years of age were included in our study. Demographic data, tumor size, Karnofsky Performance Score (KPS), and Eastern Cooperative Oncology Group Performance Status (ECOG), as well as treatment modalities, were assessed. The Geriatric 8 health status screening tool (G8) and Groningen Frailty Index (GFI) were compiled pre-and postoperatively.Results: The mean patient age was 76.86 ± 4.11 years. Forty-nine (47%) patients were female, 55 (53%) male. Sixty-seven patients underwent microsurgical tumor resection, 37 received tumor biopsy alone. Mean G8 on admission was 12.4 ± 2.0, mean GFI 5.0 ± 2.5. In our cohort, frailty was independent of patient age, tumor size, or localization. Frailty, defined by G8 and GFI, is associated with shorter overall survival (G8: p = 0.0035; GFI: p = 0.0136) and higher numbers of surgical complications (G8: p = 0.0326; GFI: p = 0.0388). Frailer patients are more likely to receive best supportive care (p = 0.004). Nevertheless, frailty did not affect adjuvant treatment decision-making toward either single-use of chemo- or radiation therapy, stratified treatment, or concomitant therapy. The surgical decision on the extent of resection was not based on pre-operative frailty.Conclusion: In our study, frailty is a predictor of poorer surgical outcomes, post-operative complications, and impaired overall survival independent of chronological age. Frailty screening tests offer an additional assessment tool to stratify geriatric patients with glioblastoma and identify those at risk for a detrimental outcome and thus should be implemented in therapeutic decision making.Harald KrenzlinDragan JankovicChristoph AlberterDarius KalasauskasChristiane WestphalenFlorian RingelNaureen KericFrontiers Media S.A.articleglioblastomafrailtyGroningen Frailty IndexG8geriatric patientsNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	glioblastoma frailty Groningen Frailty Index G8 geriatric patients Neurology. Diseases of the nervous system RC346-429
spellingShingle	glioblastoma frailty Groningen Frailty Index G8 geriatric patients Neurology. Diseases of the nervous system RC346-429 Harald Krenzlin Dragan Jankovic Christoph Alberter Darius Kalasauskas Christiane Westphalen Florian Ringel Naureen Keric Frailty in Glioblastoma Is Independent From Chronological Age
description	Objective: Treatment of glioblastoma in elderly patients is particularly challenging due to their general condition and comorbidities. Treatment decisions are often based on chronological age. Frailty screening tests promise an assessment tool to stratify geriatric patients and identify those at risk for an unfavorable outcome. This study aims to evaluate the impact of age and frailty on the surgical outcome and overall survival in geriatric patients with glioblastoma.Methods: Data acquisition was conducted as a single-center retrospective analysis. From January 1st 2015, and December 31st 2019, 104 glioblastoma patients over 70 years of age were included in our study. Demographic data, tumor size, Karnofsky Performance Score (KPS), and Eastern Cooperative Oncology Group Performance Status (ECOG), as well as treatment modalities, were assessed. The Geriatric 8 health status screening tool (G8) and Groningen Frailty Index (GFI) were compiled pre-and postoperatively.Results: The mean patient age was 76.86 ± 4.11 years. Forty-nine (47%) patients were female, 55 (53%) male. Sixty-seven patients underwent microsurgical tumor resection, 37 received tumor biopsy alone. Mean G8 on admission was 12.4 ± 2.0, mean GFI 5.0 ± 2.5. In our cohort, frailty was independent of patient age, tumor size, or localization. Frailty, defined by G8 and GFI, is associated with shorter overall survival (G8: p = 0.0035; GFI: p = 0.0136) and higher numbers of surgical complications (G8: p = 0.0326; GFI: p = 0.0388). Frailer patients are more likely to receive best supportive care (p = 0.004). Nevertheless, frailty did not affect adjuvant treatment decision-making toward either single-use of chemo- or radiation therapy, stratified treatment, or concomitant therapy. The surgical decision on the extent of resection was not based on pre-operative frailty.Conclusion: In our study, frailty is a predictor of poorer surgical outcomes, post-operative complications, and impaired overall survival independent of chronological age. Frailty screening tests offer an additional assessment tool to stratify geriatric patients with glioblastoma and identify those at risk for a detrimental outcome and thus should be implemented in therapeutic decision making.
format	article
author	Harald Krenzlin Dragan Jankovic Christoph Alberter Darius Kalasauskas Christiane Westphalen Florian Ringel Naureen Keric
author_facet	Harald Krenzlin Dragan Jankovic Christoph Alberter Darius Kalasauskas Christiane Westphalen Florian Ringel Naureen Keric
author_sort	Harald Krenzlin
title	Frailty in Glioblastoma Is Independent From Chronological Age
title_short	Frailty in Glioblastoma Is Independent From Chronological Age
title_full	Frailty in Glioblastoma Is Independent From Chronological Age
title_fullStr	Frailty in Glioblastoma Is Independent From Chronological Age
title_full_unstemmed	Frailty in Glioblastoma Is Independent From Chronological Age
title_sort	frailty in glioblastoma is independent from chronological age
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/16fdb8e62d64496a89ce3b736d630c5d
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Frailty in Glioblastoma Is Independent From Chronological Age

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