OBJECTIVES

There is scarce evidence on treatment recommendations of gliomas in the elderly population. Because no standard treatment has been established, the purpose of this study is to evaluate the relationship between surgical resection and age.

METHODS

A retrospective cohort study (1/1/2007-12/31/2016) was conducted using the national Surveillance Epidemiology and End Results (SEER) data. Patients included were > 18 years old, diagnosed with a glioma (specifically, astrocytoma, glioblastoma, or oligodendroglioma), and had a positive histology. Tumors that were grade 1, identified by autopsy, or had incomplete surgical data were excluded. Chi-squared and ANOVA were used to assess baseline characteristics in patients < 65 years old and > 65 years old. A multivariable logistic regression model was used to assess the association of surgery and age. A biopsy, subtotal resection, or total resection of the tumor was defined as receiving surgery and no intervention was defined as not receiving surgery.

RESULTS

A total of 11,861 patients were included in the population. The mean age was 58 (SD 15.8), 58% were male, 88% were white, and 61% were married. When comparing individuals < 65 years old and > 65 years old there was a statistically significant difference in receiving surgery (60% versus 40%, respectively, p<0.0001) and survival (23 [SD 23.1] months versus 9 [12.1] months, respectively, p<0.0001). Controlling for individual factors and covariates, logistic regression analyses identified a significant age effect on receiving surgery. Individuals < 65 years old had a greater odds of receiving surgery compared to individuals > 65 years old (OR 2.0 95% CI [1.82, 2.20]).

CONCLUSIONS

Results suggest that the elderly population is less likely to have a surgical resection. Further research is warranted to assess the differences in other treatment options (i.e. radiation or chemotherapy) to have a better understanding of how gliomas are being treated in the elderly population.