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Prognosis and patterns of care in elderly patients with glioma
Author(s) -
Iwamoto Fabio M.,
Reiner Anne S.,
Nayak Lakshmi,
Panageas Katherine S.,
Elkin Elena B.,
Abrey Lauren E.
Publication year - 2009
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.24612
Subject(s) - medicine , radiation therapy , logistic regression , chemotherapy , cohort , epidemiology , anaplastic astrocytoma , cancer registry , population , multivariate analysis , proportional hazards model , cancer , glioma , surgery , astrocytoma , environmental health , cancer research
BACKGROUND: The current study was conducted to evaluate the patterns of care and survival of older adults with oligodendroglioma (OLI) and astrocytoma (AST) from a large population‐based registry. METHODS: The authors identified a cohort of OLI and AST patients aged ≥65 years from Surveillance, Epidemiology and End Results (SEER) cancer registry data linked with Medicare claims between 1994 and 2002. Patients with a diagnosis of glioblastoma were excluded. The impact of demographic characteristics and comorbidities on the probability of undergoing surgical resection, radiotherapy (RT), and chemotherapy within 6 months of diagnosis was assessed using multivariate logistic regression. RESULTS: A total of 1067 patients (891 with AST and 176 with OLI) were included; the median survival was 9 months for patients with low‐grade AST, 4 months for patients with anaplastic AST, 57 months for patients with low‐grade OLI, and 9 months for patients with anaplastic OLI. Approximately 54% of patients underwent resection at the time of diagnosis; 66% received RT, and 13% received chemotherapy within 6 months of diagnosis. In a multivariate regression analysis, age and tumor grade were found to be the most significant predictors of resection, RT, or chemotherapy. Patients with anaplastic tumors were treated with resection, RT, and chemotherapy more often than patients with low‐grade tumors, and OLI patients received chemotherapy more frequently than AST. CONCLUSIONS: Data from the current study suggested that histologic diagnosis and tumor grade retained significant prognostic value in this elderly AST and OLI population. Furthermore, age and tumor grade were found to influence the probability of undergoing surgery, RT, and chemotherapy in this cohort. Cancer 2009. © 2009 American Cancer Society.