Incidence and characterization of pure non-urothelial bladder and upper tract cancers: A 10-year review.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 414-414
Author(s):  
Kanika Gupta ◽  
Ehab El Bahesh ◽  
Antoine Nafez Finianos ◽  
Brandon Clark ◽  
Samuel Simmens ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Randomized Clinical Trials ◽  
Retrospective Chart Review ◽  
The United States ◽  
Primary Treatment ◽  
Treatment Modalities ◽  
Cancer Center ◽  
Favorable Histology

414 Background: Bladder cancer is the sixth most common malignancy in the United States. Urothelial carcinoma makes up 90% of bladder cancer histology, which may be pure or mixed. It includes adenocarcinoma (Ad), squamous (SqC), glandular, sarcomatoid (St), micropapillary, small cell (SC) and plasmacytoid variants. Pure non-urothelial cancers have worse overall survival compared to urothelial cancer with mixed histologic features. However, little research has been done to characterize pure non-urothelial histologies, and there are no randomized clinical trials evaluating treatment modalities for non-urothelial cancers. This retrospective study characterizes pure non-urothelial cancers and their treatments. Methods: A retrospective chart review of the last 10 years was performed using data from the George Washington University Cancer Center Tumor Registry Data. Statistical analysis was done using the Fisher’s test and Kaplan-Meier survival curves. Results: Out of 449 consecutive patients with bladder cancers, 19 patients had pure non-urothelial carcinoma (4.2%): 7 SqC, 6 Ad, 3 SC, 2 lymphoma (Ly), and 1 St. SqC and Ad were more likely than SC to be diagnosed at an advanced stage (p = 0.04), with median age of diagnosis at 53.5 years for Ad, 68 years for SC and 69 years for Sq. None of the SC metastasized. Primary treatment for 94% of patients was a surgical intervention (9 TURBT, 2 partial cystectomy, 2 radical cystectomy, and 2 nephroureterectomy); 1 received neoadjuvant therapy. 11 patients received adjuvant chemotherapy – 7 with gemcitabine-based regimens and 10 with platinum-based regimens. While not statistically significant, median overall survival varied – 404 days for Ad, 213 days for SqC, and 1567 days for SC. Conclusions: SC was a more favorable histology when compared to SqC or Ad, presenting at an earlier stage with lower incidence of metastasis that perhaps reflected the improved overall survival. Identifying patients with more aggressive disease earlier allows for the potential role for more aggressive therapies that may result in improved outcomes. While the sample size is small, it identifies characteristics and potential differences between bladder cancer with rare histologies.

Retrospective study of patients with advanced upper urinary tract transitional cell carcinoma (UUT-TCC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14611-14611
Author(s):  
A. Dufresne ◽  
A. Fléchon ◽  
P. Pommier ◽  
J. Droz
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Transitional Cell ◽  
Treatment Modalities ◽  
Cancer Center ◽  
Time Interval ◽  
Median Response ◽  
Platinum Based Chemotherapy ◽  
Response To Chemotherapy ◽  
Clinical Records

14611 Background: UUT-TCC is a rare disease with poor prognosis. The aim of the study was to review retrospectively the outcome of 66 patients treated in a single cancer center. Methods: Clinical records of patients treated between 1993 and 2005 were reviewed to identify treatment modalities and outcome. Results: There were 47 (71%) males, median age was 60 years (range: 40–85) and UUT-TCC was associated with superficial bladder cancer in 14 (21%) patients. Forty-one patients had pT2–4 pN0–2 M0 disease after radical nephro-ureterectomy. Adjuvant treatment was: none for 25 patients, chemotherapy for 6 patients, radiotherapy for 1 patient, chemotherapy then radiotherapy for 9 patients. Twenty-seven patients relapsed after a median time interval of 12 months (range: 2–88). Fifty-two patients had metastatic disease (25 at initial diagnosis and 27 after relapse). Respectively 19 and 33 patients had one or multiple metastatic sites. Sites of metastases were: local in 12 patients, retroperitoneal lymph nodes in 30, liver in 23, lung in 19 and bone in 15. Thirty-six patients received platinum-based chemotherapy, 10 received palliative radiotherapy, 5 received best supportive care, and 1 had surgery. Response rate to chemotherapy was 40% with median response duration of 5.5 months (range: 0.2–18.5). Overall survival was 14.6 months. Conclusion: UUT-TCC has a worse prognosis than bladder TCC. However response to chemotherapy and overall survival seem worse than in metastatic bladder cancer. No significant financial relationships to disclose.

scholarly journals Differential Characteristics and Prognosis of PD-L1–Positive Endometrial Carcinomas: A Retrospective Chart Review

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1047
Author(s):  
Justin Z. Amarin ◽  
Razan Mansour ◽  
Sura Al-Ghnimat ◽  
Maysa Al-Hussaini
Keyword(s):  
Overall Survival ◽  
Tumor Cells ◽  
Chart Review ◽  
Prognostic Significance ◽  
Retrospective Chart Review ◽  
Cancer Center ◽  
High Grade ◽  
Endometrial Carcinomas

Women with endometrial carcinomas that express PD-L1 may respond better to immunotherapy. Our aim was to investigate the differential characteristics of PDL1–positive endometrial carcinomas and the prognostic significance of PDL1. We performed a retrospective chart review of 231 women with endometrial carcinomas who were managed at King Hussein Cancer Center (2007–2016) and performed immunohistochemistry for MLH1, PMS2, MSH2, MSH6, p53, and PD-L1. Overall, 89 cases (38.5%) were MMR-deficient. PD-L1 was expressed in 49 cases (21.2%) and its expression was significantly associated with MLH1/PMS2 deficiency (p = 0.044) but not MSH2/MSH6 deficiency (p = 0.59). p53 was mutant in 106 cases (46.5%), and its mutation was significantly associated with MMR proficiency (p < 0.001) but not PDL1 expression (p = 0.78). In women with endometrioid adenocarcinomas, PD-L1 expression was significantly associated with the Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) grade (p = 0.008). Overall, PDL1 expression did not significantly predict overall survival in unadjusted or adjusted analyses (p = 0.92 and 0.54, respectively). In conclusion, tumors with MLH1/PMS2 loss and high-grade endometrioid adenocarcinomas were more likely to express PDL1 in tumor cells. Further research is required to investigate whether the presence of either characteristic signals a higher likelihood of a favorable response if immunotherapy is administered.

scholarly journals Urothelial bladder carcinoma with major clinical presentation as overactive bladder, without hematuria: case report and literature review

2018 ◽  
Vol 7 (10) ◽  
pp. 4292
Author(s):  
Alexander de J. Rafaelano M. ◽  
Junior J. Araiza Navarro ◽  
María Isabel Tolentino Sosa ◽  
Fernando López Reyes ◽  
Marlene De la Peña Gutiérrez
Keyword(s):  
Bladder Cancer ◽  
Case Report ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Transitional Cell ◽  
The United States ◽  
Transitional Epithelium ◽  
Common Symptom ◽  
Macroscopic Hematuria ◽  
Adjacent Structures

The urothelial carcinoma is the most common type of bladder cancer, comprising approximately 90% of cases in the United States. The most common symptom of bladder cancer is macroscopic hematuria, increased urinary frequency, urgency, or irritative symptoms may occur. Generally, occurs in elderly people, about 9 out of 10 people are over 55 years old, with the average age at diagnosis of 73 years. Males are more likely than women to have this neoplasm with a probability of 1 in 27 (for women the probability is 1 in 89). Most bladder cancers begin in the inner layer, also called the urothelium or transitional epithelium. As it advances, it invades the layers of the bladder and can invade adjacent structures, often metastasizing to distant lymph nodes, bones, lungs or the liver. Among the cancers that originate in the bladder authors have: Urothelial carcinoma (transitional cell carcinoma), squamous cell carcinoma, adenocarcinoma, small cell carcinoma, sarcoma. Hematuria occurs in the majority of patients with urothelial carcinoma. Symptoms such as dysuria, frequency, urgency and pain may also occur, or it may also be asymptomatic.  In this case report, an atypical presentation of bladder cancer is shown, simulating the symptomatology of a Hyperactive Bladder Syndrome.

scholarly journals Malignancy Trends in HIV-Infected Patients Over the Past 10 Years in a Single-Center Retrospective Observational Study in the United States

2018 ◽  
Vol 25 (1) ◽  
pp. 107327481879795 ◽  
Author(s):  
Nancy Rihana ◽  
Sowmya Nanjappa ◽  
Cara Sullivan ◽  
Ana Paula Velez ◽  
Narach Tienchai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hodgkin Lymphoma ◽  
Anal Cancer ◽  
Invasive Cervical Cancer ◽  
Human Herpesvirus ◽  
Kaposi Sarcoma ◽  
Retrospective Chart Review ◽  
The United States ◽  
Cancer Center ◽  
Non Hodgkin Lymphoma

The introduction of antiretroviral therapy (ART) in 1995 had a dramatic impact on the morbidity and mortality of the HIV population, and subsequently, the natural history of cancer has changed. The purpose of our study was to review the prevalence of AIDS-defining malignancies and non-AIDS defining cancers (NADC), taking into consideration racial and gender variations. After the institutional review board approval, the study was conducted as a retrospective chart review of 279 HIV-infected patients who were treated at the Moffitt Cancer Center between January 1, 2000 and December 31, 2010. The demographic characteristics included gender, ethnicity, race, presence or absence of ART, and the type of malignancy reviewed. Of 233 men, 78 (33.5%) had AIDS-defining malignancies. AIDS-related non-Hodgkin lymphoma (NHL) was detected in 49 (21%) patients and Kaposi sarcoma (KS) in 29 (12%) patients. Two-thirds of male patients had NADC, with anal cancer being the most prevalent (8.5%), followed by Hodgkin lymphoma (6%). AIDS-related NHL was also the predominant malignancy for women with a prevalence of 19.5% followed by invasive cervical cancer (ICC) and breast cancer, both with a similar prevalence of 11%. Kaposi sarcoma and anal cancer were equally detected in 2% of women. The prevalence rates of AIDS-defining malignancies among those of white race were 34%, ranging from 21% for NHL to 13% for KS and 1.5% for ICC. Twenty-one (7.7%) patients had anal cancer. AIDS-defining malignancies were found in 36% of patients of black race and 60% had NHL. Non-AIDS-related NHL was the second most common malignancy, followed by breast cancer and anal cancer with a similar prevalence of 6.5%. Of 279 patients, 53% were taking ART; 39.4% were not taking ART; and in 7.5% of the patients, it was unknown if they were taking ART. In the ART era, our study found NADC to be more prevalent than AIDS-defining malignancies with 60% versus 40%, respectively. Non-Hodgkin lymphoma remained the most common AIDS-related malignancy in both genders. Among the patients with NADC, anal cancer was the predominant malignancy. The increasing incidence of some of the NADC is expected as this population is living longer with chronic exposure of viral replication of virus with oncogenic potential such as Human papillomavirus (HPV), Hepatitis B virus (HBV), Epstein-Barr virus (EBV), and Human herpesvirus 8 (HHV-8). Early ART initiation, aggressive vaccination, and judicious cancer screening are the cornerstone of cancer prevention of this growing population.

scholarly journals COVID-19 and end stage renal disease treatment modalities in the United States

2021 ◽  
pp. 003-009
Author(s):  
Sullivan John D
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
The United States ◽  
Primary Treatment ◽  
Treatment Modalities ◽  
Health Coverage ◽  
Home Hemodialysis ◽  
Primary Treatment Modality ◽  
Stage Renal Disease ◽  
End Stage

From the establishment of nearly universal health coverage for end stage renal disease in 1972 to 2021, the primary treatment modality has been in-center hemodialysis despite significant advances in home therapies such as peritoneal dialysis and home hemodialysis. There are many theories as to why peritoneal and home hemodialysis lack so far behind in prescriptions with profitability and or a patient’s compliance or support leading the logical explanations. But 2020 was a different year with the surge in COVID-19 cases.

scholarly journals Management of eight labor and delivery patients dependent on buprenorphine (Subutex™): A retrospective chart review

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 7 ◽  
Author(s):  
Solina Tith ◽  
Garinder Bining ◽  
Laurent A. Bollag
Keyword(s):  
Chart Review ◽  
Case Series ◽  
Retrospective Chart Review ◽  
The United States ◽  
Treatment Modalities ◽  
Evidence Based ◽  
Labor And Delivery ◽  
Opioid Agonists ◽  
Opioid Administration ◽  
Evidence Based Guidelines

Background: Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by “The American College of Obstetrics and Gynecology” as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists’ unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia. We reviewed our management and outcomes in this medically complex population. Methods: An Institutional Review Board (IRB) approved retrospective chart review was conducted of women admitted to the University of Washington Medical Center Labor and Delivery unit from July 2012 to November 2013 using buprenorphine. All deliveries, including intrauterine fetal demise, were included. Results: Eight women were admitted during this period to our L&D floor on buprenorphine. All required peri-partum anesthetic management either for labor and/or cesarean delivery management. Analgesic management included dilaudid or fentanyl PCA and/or continued epidural infusion, and in one instance ketamine infusion, while the pre-admission buprenorphine regimen was continued. Five babies were viable, two women experienced intrauterine fetal death at 22 and 36 weeks gestational age (GSA), respectively, and one neonate died shortly after delivery due to a congenital diaphragmatic hernia. Conclusions: This case series illuminates the medical complexity of parturients using buprenorphine. Different treatment modalities in the absence of evidence-based guidelines included additional opioid administration and continued epidural analgesia. The management of post-cesarean pain in patients on partial μ-opioid agonists remains complex and variable, and evidence-based guidelines could be useful for clinicians to direct care.

Recurrent vulvar squamous cell carcinoma: An analysis of clinical outcomes by treatment modality including surgery, chemotherapy, and radiation.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18033-e18033
Author(s):  
Trish Dinh ◽  
Natalie Andrews Wright ◽  
Hari Iyer ◽  
Johanne I Weberpals
Keyword(s):  
Surgical Management ◽  
Treatment Modality ◽  
Standard Treatment ◽  
Treatment Options ◽  
Retrospective Chart Review ◽  
Primary Treatment ◽  
Outcome Data ◽  
Cancer Center ◽  
Real World Data ◽  
Significant Difference

e18033 Background: Recurrent VSCC carries a poor prognosis, but real-world data on outcomes with standard treatment options are lacking. Specifically, progression free survival (PFS) in recurrent VSCC is ill-defined which is problematic for the design of clinical trials with novel therapies. We aim to address the paucity of outcome data in recurrent VSCC and to compare PFS and overall survival (OS) in patients (pts) undergoing surgery, chemotherapy, radiotherapy or a combination of these treatments. Methods: A retrospective chart review identified 246 pts from 2000-2018 diagnosed with VSCC treated at the Ottawa Hospital Cancer Center and 61 pts with recurrent disease. Data collected included patient demographics, tumour characteristics, recurrence pattern, and treatment modality (surgery only, surgery with chemotherapy, surgery with radiation, surgery with chemoradiation, chemoradiation only, chemotherapy only, or radiation only). Descriptive statistical analysis is reported. Results: Among all study pts, the stage distribution was stage I: 28%, II: 19%, III: 43% and IV: 10%. 61% of pts had one recurrence, 36% had two recurrences, and 3% had three recurrences. The 5-year survival rate was 78% for non-recurrent VSCC vs. 33% for recurrent cases. The median OS for all recurrent and non-recurrent cases was 3.7 years and 13.5 years, respectively. For primary treatment, 87% underwent surgical treatment, of which 60% also had radiation or chemoradiation. The most common treatments for first recurrence were: surgery (25%), radiation (20%), no treatment (16%) and chemotherapy (14%), and for second recurrence: no treatment (50%), radiation (25%), surgery (17%) and chemotherapy (8%). The median PFS after primary treatment and after first and second recurrences were 8.7, 5.3 and 1.4 months (mo), respectively, with no significant difference between treatment regimens. However, when grouped (surgery with or without chemotherapy, radiation or chemoradiation vs. non-surgical management), there was a significant PFS benefit for surgical (15.6 mo) over non-surgical management (0.7 mo) in the treatment of a second recurrence (p = 0.05). Conclusions: At our centre, surgery and radiation have been the mainstay of treatment for recurrent VSCC with particular advantage of surgery in the treatment of a second recurrence. Our study establishes a baseline for VSCC outcomes following standard treatment. Accurate PFS data is an important outcome for the design of future studies in recurrent VSCC with new drug therapies.

Racial disparities in the outcomes of transitional cell carcinoma of the bladder: A population-based analysis.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 577-577
Author(s):  
Firas Baidoun ◽  
Inas A. Ruhban ◽  
Anas M. Saad ◽  
Mohamed M. Gad ◽  
Khalid Jazieh ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Transitional Cell Carcinoma ◽  
Racial Disparities ◽  
Cell Carcinoma ◽  
Transitional Cell ◽  
Stage Iv ◽  
The United States ◽  
Pacific Islanders ◽  
The Us

577 Background: Bladder cancer is the most common type of genitourinary malignancy and is the fourth most common cancer in men in the US. Transitional cell carcinoma (TCC) of the bladder accounts for most bladder cancer cases. Previous studies have observed racial disparities in the prognosis between white and black populations with very little mentioned about other ethnicities and race groups that are part of the United States population. We hereby, present a detailed and comprehensive analysis of racial disparities in TCC survival in the US. Methods: Using the data from surveillance Epidemiology and End results (SEER) database, we identified patients with TCC between 1992 and 2015. We used multivariable covariate-adjusted Cox models to analyze the overall and TCC-specific survival of patients according to their race. Results: We evaluated 176,388 patients with TCC and after we adjusted for age, sex, race, stage, grade, and undergoing cancer-targeted surgery, we found that Asians/Pacific Islanders and Hispanics had a better overall survival when compared to whites (HR= 0.792, 95% CI [0.761-0.824], P<.001 and HR = 0.941, 95% CI [0.909-0.974], P = .001, respectively). Asians/Pacific Islanders also showed better TCC specific survival (HR = 0.843, 95% CI [0.759-0.894], P<.001). Blacks had worse overall survival and TCC-specific survival (HR =1.221, 95% CI [1.181-1.262], P <.001 and HR =1.325, 95% CI [1.268- 1.384], P <.001, respectively). When stage IV TCC was analyzed separately, only Hispanics showed better overall and TCC specific survival when compared to whites (HR = 0.896, 95% CI [0.806-0.997], P = 0.044 and HR = 0.891, 95% CI [0.797-0.996], P = 0.42). Conclusions: Asians/Pacific Islanders have better overall and TCC-specific outcome while blacks have the worst outcome compared to whites. Hispanics have better overall and cancer specific survival in stage IV TCC. These disparities likely related to different and complex factors from lifestyle and chemical exposure to genetic factors. Further studies can help us more in understanding and approaching this malignancy in different race groups.

A retrospective real-world major bleeding (MB) comparison of direct oral anticoagulants (DOAC) and low molecular weight heparin (LMWH) in genitourinary cancer-associated venous thromboembolism (GU-CAVTE) with reported randomized clinical trials (RTC).

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 410-410
Author(s):  
Ulyana Dashkevych ◽  
Eric Brucks ◽  
Kathylynn Saboda ◽  
Juan Chipollini ◽  
Hani M. Babiker ◽  
...  
Keyword(s):  
High Risk ◽  
Real World ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Retrospective Chart Review ◽  
Cancer Center ◽  
Recurrent Vte

410 Background: MB is a serious complication in patients with CAVTE receiving treatment with DOAC or LMWH. The most recent meta-analysis of the four major RCT showed that MB events rate were similar among the DOAC and LMWH group, however, it was noted that MB occurred at GU site 4.9 times more in DOAC than LMWH patients. While GUCA (e.g. bladder and testicular) are considered to be high-risk based on the Khorana Score, they were underrepresented among the RCT ( < 12%). We present a Real-World retrospective cohort study analyzing the MB rates in patients presenting with GU-CAVTE treated either by a DOAC or LMWH compared to those of the RTC. Methods: We performed a retrospective chart review of patients with a diagnosed GUCA and VTE who presented to The University of Arizona Cancer Center (UACC) and were subsequently placed on anticoagulant therapy with either a DOAC or LMWH from 11/2013-4/2020. MB outcome was defined as documented Hgb drop of ≥2 g/dL, ≥2 units of PRBC, MB in a critical site, or contributing to death. MB was extracted and compared from the SELECT D, ADAM VTE, and Caravaggio for DOAC and Hokusai for the LMWH control arm with the GUCA subgroup. Recurrent VTE was collected. In situations where there was insufficient data to categorize individuals, those individuals were excluded from the analysis. The proportion of MB reported in each study were compared using a binomial test. Results: Our review included 56 patients with similar baseline characteristics to the RCT, who were prescribed enoxaparin (n = 13), apixaban (n = 27) and rivaroxaban (n = 16). Our UACC data was compared to the RCT reported MB outcomes with rivaroxaban (12% vs 8%, [p = 0.63]), apixaban (11% vs 6%, [p = 0.40]), and LMWH (both 0 vs 1% [p = 0.67]). No statistical difference among DOAC selection [p = 0.90]. Our UACC rate of MB in patients with GUCA for both DOAC combined versus LWMH were 11.6% (5/43) and 0% [p = 0.1910], compared to the RCT GU subgroup was 5.7% (6/104) [p = 0.02] and 0.6% (1/175) [p = 1.0], respectively. Furthermore, our data found no statistical significance difference among the recurrent VTE rate among DOAC, LMWH, UACC Retrospective or RCT events. Conclusions: In agreement with the four major RCT, our study demonstrated that patients with high-risk GUCA and underlying VTE treated with a DOAC had a non-significant higher incidence of MB compared to those treated with LMWH. Further, our Real-World experience showed that GUCA DOAC had a significantly higher MB event rate compared to the RCT subgroup population. We acknowledge there are inherent biases in all retrospective studies and RCT. These data support the idea that DOAC should be further studied and used with caution in patients with a high risk of bleeding. We recommend LMWH being the safest anticoagulation modality for High-Risk Bleeding GU malignancy.

scholarly journals HOUT-18. TREATMENT STRATEGIES FOR GLIOBLASTOMA IN OLDER PATIENTS: AGE IS JUST A NUMBER

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi115-vi116
Author(s):  
Michael Youssef ◽  
Ethan Ludmir ◽  
Jacob Mandel ◽  
Akash Patel ◽  
Ali Jalali ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Trials ◽  
Multivariable Analysis ◽  
Treatment Strategies ◽  
Retrospective Chart Review ◽  
High Volume ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Optimal Care ◽  
Poor Overall Survival

Abstract BACKGROUND Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in clinical trials (including EORTC 22981) as well as their historically-poor overall survival. METHODS Retrospective chart review was conducted at a single high-volume cancer center for newly-diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. RESULTS A total of 158 newly-diagnosed GBM patients aged 65 years and older were identified. 144 patients (91.1%) underwent radiation therapy. One-hundred thirty patient (90.3%) received concurrent temozolomide with radiotherapy. A minority of patients (23%) discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temodar. The median overall survival (OS) time for our cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p=0.002, HR 0.46; 95% CI: 0.63–0.82), completing planned course of radiation (p=0.01, HR 0.29; 95% CI: 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p=0.01, HR 2.62; 95% CI: 1.67–4.12) were associated with improved OS. CONCLUSIONS Our cohort of elderly GBM patients were predominately treated with a standard of care based on EORTC 22981. Despite their age, these patients tolerated treatment well and had a favorable overall survival compared to outcomes reported for patients treated on EORTC 22981. Using age alone as the reason to de-escalate treatment or as an exclusionary criteria in clinical trials should be discouraged.

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