Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients
Abstract
:1. Introduction
2. Material and Methods
3. Statistical Analysis
4. Results
5. Discussion
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Category | N (%) |
---|---|---|
Number of patients | 113 | |
Age at diagnosis | Mean ± SD | 71.7 ± 4.6 |
Median | 71.3 (range 65–84) | |
Gender | Male | 72 (64) |
Female | 41 (36) | |
MGMT | Methylated | 42 (44) |
Not methylated | 54 (56) | |
KPS | 100–70 | 90 (80) |
60–30 | 23 (20) | |
Type of surgery | Radical | 37 (33) |
Partial | 72 (63) | |
Biopsy | 4 (4) | |
Treatment | Yes | 106 (94) |
No | 7 (6) | |
Type of treatment | RT + TMZ | 90 (80) |
RT 60 Gy (standard) | 54 (60) | |
RT 40 Gy (hypofractionated) | 36 (40) | |
TMZ or RT alone | 16 (14) | |
Best supportive care | 7 (6) | |
Maintenance TMZ cycles (median) | 3.9 | |
CGA | Fit | 40 (35) |
Vulnerable | 33 (30) | |
Frail | 40 (35) |
Variables | Fit | Vulnerable | Frail | p |
---|---|---|---|---|
RT+TMZ | 39/40 (98%) | 30/33 (90%) | 21/40 (52%) | <0.001 |
RT 60 Gy (standard) | 25/29 (64%) | 21/30 (70%) | 8/21 (38%) | 0.06 |
RT 40 Gy (hypofractionated) | 14/39 (36%) | 9/30 (30%) | 13/21 (62%) | 0.06 |
KPS 100–70 | 40/40 (100%) | 31/33 (94%) | 19/40 (47%) | <0.001 |
Maintenance TMZ Cycles (median) | 5.2 | 5 | 2.8 | 0.03 |
Administration of TMZ | 40/40 (100%) | 31/33 (94%) | 34/40 (85%) | 0.03 |
Radical Surgery | 18/40 (45%) | 10/33 (33%) | 9/40 (22%) | 0.09 |
Biopsy | 0/40 (0%) | 1/33 (3%) | 3/40 (7%) | 0.2 |
Methylated MGMT | 15/34 (44%) | 16/32 (50%) | 15/30 (50%) | 0.8 |
Univariate Analysis | |||||||
---|---|---|---|---|---|---|---|
Variables | PFS | OS | |||||
Median (ms) | 95% CI | p | Median (ms) | 95% CI | p | ||
CGA | 0.2 | 0.1 | |||||
Fit | 11.2 | 6.07–16.4 | 16.5 | 14.6–18.2 | |||
Vulnerable | 7.7 | 4.6–10.7 | 12.1 | 8.1–16.1 | |||
Frail | 7.1 | 5.7–8.4 | 10.3 | 8.8–11.8 | |||
CGA (fit vs. unfit) | 0.25 | 0.04 | |||||
Fit | 11.2 | 6.07–16.4 | 16.5 | 14.6–18.2 | |||
Unfit | 7.2 | 5.8–8.6 | 10.6 | 8.3–12.9 | |||
MGMT | 0.002 | 0.01 | |||||
met | 11.7 | 8.8–14.5 | 16.4 | 11.9–20.9 | |||
unmet | 7.2 | 6.3–8.1 | 12.1 | 9.7–14.5 | |||
Radical surgery | 0.3 | 0.1 | |||||
yes | 10.3 | 7.3–13.3 | 14.73 | 11.9–17.5 | |||
no | 7.1 | 6.2–7.9 | 10.7 | 7.9–13.5 | |||
KPS | <0.001 | 0.008 | |||||
100–70 | 9.4 | 6.8–11.9 | 14.3 | 12.05–16.5 | |||
≤60 | 6.0 | 4.9–7.04 | 10.3 | 3.9–16.6 | |||
RT+TMZ | 0.006 | 0.001 | |||||
yes | 8.1 | 6.1–10.1 | 14.3 | 12.4–16.1 | |||
no | 6 | 2.5–9.4 | 8.2 | 5.7–10.8 |
Multivariate Analysis | ||||||
---|---|---|---|---|---|---|
Variables | PFS | OS | ||||
HR | 95% CI | p | HR | 95% CI | p | |
CGA | ||||||
Fit | Rif. | Rif. | ||||
Vulnerable | 1.1 | 0.4–1.7 | 0.7 | 1.5 | 1.1–2.09 | 0.05 |
Frail | 1.6 | 0.7–3.3 | 0.2 | 2.2 | 1.2–5.4 | 0.04 |
CGA (unfit vs. fit) | - | - | - | 1.8 | 1.2–2.8 | 0.02 |
MGMT (met vs. unmet) | 0.4 | 0.2–0.8 | 0.009 | 0.4 | 0.2–0.7 | 0.001 |
Radical Surgery (yes vs. no) | - | - | - | 0.9 | 0.7–1.2 | 0.7 |
KPS (100–70 vs. ≤60) | 0.4 | 0.1–0.8 | 0.01 | 0.4 | 0.2–0.9 | 0.05 |
RT+TMZ (yes vs. not) | 0.7 | 0.3–1.5 | 0.4 | 0.8 | 0.4–1.5 | 0.5 |
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Lombardi, G.; Bergo, E.; Caccese, M.; Padovan, M.; Bellu, L.; Brunello, A.; Zagonel, V. Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients. Cancers 2019, 11, 1509. https://doi.org/10.3390/cancers11101509
Lombardi G, Bergo E, Caccese M, Padovan M, Bellu L, Brunello A, Zagonel V. Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients. Cancers. 2019; 11(10):1509. https://doi.org/10.3390/cancers11101509
Chicago/Turabian StyleLombardi, Giuseppe, Eleonora Bergo, Mario Caccese, Marta Padovan, Luisa Bellu, Antonella Brunello, and Vittorina Zagonel. 2019. "Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients" Cancers 11, no. 10: 1509. https://doi.org/10.3390/cancers11101509