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

David A. Schomas, Nadia N. Laack, Paul D. Brown

Research output: Contribution to journalArticle

28 Scopus citations

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 (≥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, 55-74years). 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.

Original languageEnglish (US)
Pages (from-to)3969-3978
Number of pages10
JournalCancer
Volume115
Issue number17
DOIs
StatePublished - Sep 1 2009

Keywords

  • Adult
  • Combined modality therapy
  • Low-grade glioma
  • Radiotherapy
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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