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@ARTICLE{DaoTrong:186780,
author = {P. Dao Trong and M. Gluszak and D. Reuss$^*$ and A. von
Deimling$^*$ and A. Wick and L. König and J. Debus and C.
Herold-Mende and A. Unterberg and C. Jungk},
title = {{I}socitrate-dehydrogenase-mutant lower grade glioma in
elderly patients: treatment and outcome in a molecularly
characterized contemporary cohort.},
journal = {Journal of neuro-oncology},
volume = {161},
number = {3},
issn = {0167-594x},
address = {Dordrecht [u.a.]},
publisher = {Springer Science + Business Media B.V},
reportid = {DKFZ-2023-00108},
pages = {605-615},
year = {2023},
note = {2023 Feb;161(3):605-615},
abstract = {Lower-grade glioma (LGG) is rare among patients above the
age of 60 ('elderly'). Previous studies reported poor
outcome, likely due to the inclusion of isocitrate
dehydrogenase (IDH) wildtype astrocytomas and advocated
defensive surgical and adjuvant treatment. This study set
out to question this paradigm analyzing a contemporary
cohort of patients with IDH mutant astrocytoma and
oligodendroglioma WHO grade 2 and 3.Elderly patients treated
in our department for a supratentorial, hemispheric LGG
between 2009 and 2019 were retrospectively analyzed for
patient-, tumor- and treatment-related factors and
progression-free survival (PFS) and compared to patients
aged under 60. Inclusion required the availability of
subtype-defining molecular data and pre- and post-operative
tumor volumes.207 patients were included, among those 21
elderlies $(10\%).$ PFS was comparable between elderly and
younger patients (46 vs. 54 months; p = 0.634).
Oligodendroglioma was more common in the elderly $(76\%$ vs.
$46\%;$ p = 0.011). Most patients underwent tumor resection
(elderly: $81\%$ vs. younger: $91\%;$ p = 0.246) yielding
comparable residual tumor volumes (elderly: 7.8 cm3;
younger: 4.1 cm3; p = 0.137). Adjuvant treatment was
administered in $76\%$ of elderly and $61\%$ of younger
patients (p = 0.163). Uni- and multi-variate survival
analyses identified a tumor crossing the midline, surgical
strategy, and pre- and post-operative tumor volumes as
prognostic factors.Elderly patients constitute a small
fraction of molecularly characterized LGGs. In contrast to
previous reports, favorable surgical and survival outcomes
were achieved in our series comparable to those of younger
patients. Thus, intensified treatment including maximal safe
resection should be advocated in elderly patients whenever
feasible.},
keywords = {Elderly (Other) / Isocitrate dehydrogenase mutant glioma
(Other) / Lower grade glioma (Other) / WHO classification
(Other)},
cin = {B300 / HD01},
ddc = {610},
cid = {I:(DE-He78)B300-20160331 / I:(DE-He78)HD01-20160331},
pnm = {312 - Funktionelle und strukturelle Genomforschung
(POF4-312)},
pid = {G:(DE-HGF)POF4-312},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:36648586},
doi = {10.1007/s11060-022-04230-1},
url = {https://inrepo02.dkfz.de/record/186780},
}