Newly Diagnosed Glioblastoma in Elderly Patients

Yuen, Carlen; Barbaro, Marissa; Haggiagi, Aya

doi:10.1007/s11912-022-01201-7

Cited by 7 publications

(2 citation statements)

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“…Multiple studies report the necessity to advance and evaluate treatment approaches for the elderly patient cohort ( Braun and Ahluwalia, 2017 ; Yuen et al, 2022 ). It remains unclear whether awake surgery is feasible in higher aged patients.…”

Section: Discussionmentioning

confidence: 99%

Toward a systematic grading for the selection of patients to undergo awake surgery: identifying suitable predictor variables

Kram,

Neu,

Schroeder

et al. 2024

Front. Hum. Neurosci.

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BackgroundAwake craniotomy is the standard of care for treating language eloquent gliomas. However, depending on preoperative functionality, it is not feasible in each patient and selection criteria are highly heterogeneous. Thus, this study aimed to identify broadly applicable predictor variables allowing for a more systematic and objective patient selection.MethodsWe performed post-hoc analyses of preoperative language status, patient and tumor characteristics including language eloquence of 96 glioma patients treated in a single neurosurgical center between 05/2018 and 01/2021. Multinomial logistic regression and stepwise variable selection were applied to identify significant predictors of awake surgery feasibility.ResultsStepwise backward selection confirmed that a higher number of paraphasias, lower age, and high language eloquence level were suitable indicators for an awake surgery in our cohort. Subsequent descriptive and ROC-analyses indicated a cut-off at ≤54 years and a language eloquence level of at least 6 for awake surgeries, which require further validation. A high language eloquence, lower age, preexisting semantic and phonological aphasic symptoms have shown to be suitable predictors.ConclusionThe combination of these factors may act as a basis for a systematic and standardized grading of patients’ suitability for an awake craniotomy which is easily integrable into the preoperative workflow across neurosurgical centers.

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Section: Discussionmentioning

confidence: 99%

Toward a systematic grading for the selection of patients to undergo awake surgery: identifying suitable predictor variables

Kram,

Neu,

Schroeder

et al. 2024

Front. Hum. Neurosci.

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“…Age‐dependent factors have been reported to be critical for GB prognosis [16]. For example, elderly GB patients have a better prognosis based on O6‐methylguanine (O6‐MeG)‐DNA methyltransferase ( MGMT ) status [17].…”

Section: Introductionmentioning

confidence: 99%

CD8+CD103+PD1+TIM3+ T cells in glioblastoma microenvironment correlate with prognosis

Romagnoli,

D'Alessandris,

Capone

et al. 2023

Immunology

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Glioblastoma, isocitrate dehydrogenase‐wildtype (GB), is the most common and aggressive primary brain malignancy with poor outcome. Immune checkpoint inhibitors (ICIs) have been tested in GB and, despite disappointing results, the identification of a small subgroup of responders underlies the need to improve our understanding of the tumour microenvironment (TME) immunity. This study aimed to determine whether the expression of selected immune checkpoints on tissue‐resident memory T cells (Trm) may predict patient outcome. We conducted a single cohort observational study. Tumour samples were collected from 45 patients with histologically confirmed GB (WHO grade 4) and processed to obtain single‐cell suspensions. Patients were assessed for the correlation of Trm phenotype with overall survival (OS) or progression‐free survival (PFS) using multiparametric flow cytometry and uni/multivariate analyses. Levels of Trm expressing programmed cell death protein 1 (PD1) and T cell immunoglobulin and mucin domain‐containing protein 3 (TIM3) were found to be linked to clinical outcome. Low frequency of Trm expressing PD1 or TIM3 or both markers defined subgroups as independent positive prognostic factors for patient survival. On multivariate analysis, low CD8+CD103+PD1+TIM3+ Trm and Karnofsky performance status (KPS) ≥70 were confirmed to be the most predictive independent factors associated with longer OS (hazard ratios—HR [95%CI]: 0.14 [0.04–0.52] p < 0.001, 0.39 [0.16–0.96] p = 0.04, respectively). The CD8+CD103+ Trm subgroups were also age‐related predictors for survival in GB.

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