Review of "Surgical outcomes for older patients with glioblastoma multiforme: preoperative factors associated with decreased survival Clinical article"

Object As the population ages, the incidence of glioblastoma multiforme (GBM) among older patients (age > 65 years) will increase. Older patients, unlike their younger counterparts, are not often offered aggressive surgery because of their age, comorbidities, and potential inability to tolerate surgery. The goal of this study was to identify preoperative factors associated with decreased survival for older patients who underwent resection of a GBM. The identification of these factors may provide insight into which patients would benefit most from aggressive surgery. Methods All patients older than 65 years who underwent nonbiopsy resection of an intracranial GBM at a single institution between 1997 and 2007 were retrospectively reviewed. Factors associated with overall survival were assessed using multivariate proportional hazards regression analysis after controlling for peri- and postoperative factors known to be associated with outcome (extent of resection, carmustine wafer implantation, temozolomide chemotherapy, and radiation therapy). Variables with p < 0.05 were considered statistically significant. Results A total of 129 patients with an average age of 73 ± 5 years met the inclusion/exclusion criteria. At last follow-up, all 129 patients had died, with a median survival of 7.9 months. The preoperative factors that were independently associated with decreased survival were Karnofsky Performance Scale (KPS) score less than 80 (p = 0.001), chronic obstructive pulmonary disease (p = 0.01), motor deficit (p = 0.01), language deficit (p = 0.005), cognitive deficit (p = 0.02), and tumor size larger than 4 cm (p = 0.002). Patients with 0–1 (Group 1), 2–3 (Group 2), and 4–6 (Group 3) of these factors had statistically different survival times, where the median survival was 9.2, 5.5, and 4.4 months, respectively. In log-rank analysis, the median survival for Group 1 was significantly longer than that for Group 2 (p = 0.004) and Group 3 (p < 0.0001), while Group 2 had longer survival than Group 3 (p = 0.02). Conclusions Older patients with an increasing number of these factors may not benefit as much from aggressive surgery as patients with fewer factors. This may provide insight into identifying which patients older than 65 years of age may benefit from aggressive surgery.

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Long‐term Surgical Outcomes after Resection of Presacral Tumours and Risk Factors Associated with Recurrence

Colorectal Disease ◽

10.1111/codi.15691 ◽

2021 ◽

Author(s):

Di Zhang ◽

Yizhou Sun ◽

Lei Lian ◽

Bang Hu ◽

Heng Zhang ◽

...

Keyword(s):

Risk Factors ◽

Surgical Outcomes ◽

Factors Associated

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Glioblastoma Multiforme: an Advanced Analysis of 153 Patients and Review of the Literature

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0037-1603199 ◽

2017 ◽

Vol 36 (02) ◽

pp. 080-090 ◽

Cited By ~ 1

Author(s):

Mohammad Nikdad ◽

Farshid Farhan ◽

Milad Shafizadeh ◽

Atefeh Mirmohseni ◽

Mohsen Afarideh ◽

...

Keyword(s):

Glioblastoma Multiforme ◽

Local Recurrence ◽

Karnofsky Performance Status ◽

Performance Status ◽

Tertiary Care ◽

Cox Proportional Hazards ◽

Recurrence Rates ◽

Operative Method ◽

Factors Associated ◽

Advanced Analysis

Objective Glioblastoma multiforme (GBM) is an aggressive primary tumor with frequent recurrences that leaves patients with a short survival time and a low quality of life. The aim of this study was to review the prognostic factors in patients with glioblastoma multiforme. Material and Methods The focus of this retrospective study was a group of 153 patients with supratentorial GBM tumors, who were admitted to a tertiary-care referral academic center from 2005 to 2013. The factors associated with survival and local recurrence were assessed using the hazard ratio (HR) function of Cox proportional hazards regression and neural network analysis. Results Out of the 153 patients, 99 (64.7%) were male. The average age of the patients was 55.69 ± 15.10 years. The median overall survival (OS) and progression-free survival (PFS) rates were 14.0 and 7.10 months respectively. In the multivariate analysis, age (HR = 2.939, p < 0.001), operative method (HR = 7.416, p < 0.001), temozolomide (TMZ, HR = 11.723, p < 0.001), lomustine (CCNU, HR = 8.139, p < 0.001), occipital lobe involvement (HR = 3.088, p < 0.001) and Karnofsky Performance Status (KPS, HR = 4.831, p < 0.001) scores were shown to be significantly associated with a higher OS rate. Furthermore, higher KPS (HR = 7.292, p < 0.001) readings, the operative method (HR = 0.493, p = 0.005), the use of CCNU (HR = 2.047, p = 0.003) and resection versus chemotherapy (HR = 0.171, p < 0.001) were the significant factors associated with the local recurrence of the tumor. Conclusion Our findings suggest that the use of CCNU and TMZ, the operative method and higher KPS readings are associated with both higher survival and lower local recurrence rates.

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ASTHMA IN OLDER PATIENTS: FACTORS ASSOCIATED WITH HOSPITALIZATION

PEDIATRICS ◽

10.1542/peds.112.s2.477a ◽

2003 ◽

Vol 112 (Supplement_2) ◽

pp. 477-477

Author(s):

Allen Adinoff

Keyword(s):

Older Patients ◽

Factors Associated

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Preoperative Factors Associated With Antiepileptic Drug Withdrawal Following Surgery for Intractable Temporal Lobe Epilepsy

Neurologia medico-chirurgica ◽

10.2176/nmc.51.344 ◽

2011 ◽

Vol 51 (5) ◽

pp. 344-348 ◽

Cited By ~ 6

Author(s):

Taketoshi MAEHARA ◽

Kikuo OHNO

Keyword(s):

Temporal Lobe Epilepsy ◽

Antiepileptic Drug ◽

Temporal Lobe ◽

Drug Withdrawal ◽

Factors Associated ◽

Antiepileptic Drug Withdrawal ◽

Preoperative Factors

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Factors Associated With Primary Care Physicians’ Recognition of Cognitive Impairment in Their Older Patients

Alzheimer Disease & Associated Disorders ◽

10.1097/wad.0000000000000039 ◽

2014 ◽

Vol 28 (4) ◽

pp. 320-325 ◽

Cited By ~ 14

Author(s):

Mary C. Tierney ◽

Gary Naglie ◽

Ross Upshur ◽

Liisa Jaakkimainen ◽

Rahim Moineddin ◽

...

Keyword(s):

Primary Care ◽

Cognitive Impairment ◽

Primary Care Physicians ◽

Older Patients ◽

Factors Associated

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The application of updating PIM-Taiwan criteria in clinic-visiting older patients with polypharmacy

Therapeutic Advances in Drug Safety ◽

10.1177/2042098618804493 ◽

2018 ◽

Vol 9 (12) ◽

pp. 699-709 ◽

Cited By ~ 2

Author(s):

Chirn-Bin Chang ◽

Hsiu-Yun Lai ◽

Shinn-Jang Hwang ◽

Shu-Yu Yang ◽

Ru-Shu Wu ◽

...

Keyword(s):

Chronic Conditions ◽

Medication Safety ◽

Older Patients ◽

Bivariate Analysis ◽

Potentially Inappropriate Medications ◽

Safety Review ◽

Factors Associated ◽

Logistic Regressions ◽

Inappropriate Medications ◽

Country Specific

Background: PIM-Taiwan criteria were first established in 2010 for potentially inappropriate medications (PIMs). Currently, updating of PIM criteria is mandatory because of newly established evidence and newly developed medications. This study aims to evaluate the prevalence of PIM based on country-specific PIM criteria and factors associated with PIM use by applying 2010 version and newly updating PIM-Taiwan criteria in a cohort with polypharmacy. Methods: The baseline data of Medication Safety Review Clinic Taiwan (MSRC–Taiwan) study were used to investigate the prevalence of PIMs. Older patients (aged ⩾65 years) who were either having polypharmacy or visited ⩾3 different physicians were enrolled between August and October 2007. Bivariate analysis and multivariate logistic regressions were used to evaluate the factors associated with PIM use. Results: The prevalence of having at least one PIM was 46.1% for 2010 version and increased to 74.6% for 2018 version. The average number of PIMs generally to be avoided per patient also increased for 2018 version (0.2 versus 1.2, p < 0.0001). In contrast, the average number of PIMs considering chronic conditions per patient decreased (0.6 versus 0.3, p < 0.001). The associated chronic conditions of PIM users were distinct between 2010 and 2018 version. The major leading PIMs were benzodiazepines (BZDs) in both versions of criteria. Conclusions: As there were significant differences in medication lists between PIM-Taiwan version 2010 and 2018, the prevalence of PIM and factors associated with PIM users varied accordingly. Physicians should pay special attention before prescribing BZDs which keep being the major leading PIM.

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Frailty Screening and Pre-habilitation in Older Spine Patients – Reversing the Effects of Sedentary Life-styles to Improve Surgical Outcomes for Older Patients and Reduce Healthcare Costs

Journal of Osteoporosis and Physical Activity ◽

10.4172/2329-9509.1000171 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Yonge RP ◽

Berven SH

Keyword(s):

Surgical Outcomes ◽

Healthcare Costs ◽

Older Patients ◽

Life Styles ◽

Sedentary Life

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Surgical Outcomes and EEG Prognostic Factors After Stereotactic Laser Amygdalohippocampectomy for Mesial Temporal Lobe Epilepsy

Frontiers in Neurology ◽

10.3389/fneur.2021.654668 ◽

2021 ◽

Vol 12 ◽

Author(s):

Shasha Wu ◽

Naoum P. Issa ◽

Maureen Lacy ◽

David Satzer ◽

Sandra L. Rose ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Surgical Outcomes ◽

Mesial Temporal Lobe Epilepsy ◽

Seizure Freedom ◽

Seizure Recurrence ◽

Factors Associated ◽

Scalp Eeg ◽

Mesial Temporal Lobe

Objective: To assess the seizure outcomes of stereotactic laser amygdalohippocampectomy (SLAH) in consecutive patients with mesial temporal lobe epilepsy (mTLE) in a single center and identify scalp EEG and imaging factors in the presurgical evaluation that correlate with post-surgical seizure recurrence.Methods: We retrospectively reviewed the medical and EEG records of 30 patients with drug-resistant mTLE who underwent SLAH and had at least 1 year of follow-up. Surgical outcomes were classified using the Engel scale. Univariate hazard ratios were used to evaluate the risk factors associated with seizure recurrence after SLAH.Results: The overall Engel class I outcome after SLAH was 13/30 (43%), with a mean postoperative follow-up of 48.9 ± 17.6 months. Scalp EEG findings of interictal regional slow activity (IRSA) on the side of surgery (HR = 4.05, p = 0.005) and non-lateralizing or contra-lateralizing seizure onset (HR = 4.31, p = 0.006) were negatively correlated with postsurgical seizure freedom. Scalp EEG with either one of the above features strongly predicted seizure recurrence after surgery (HR = 7.13, p < 0.001) with 100% sensitivity and 71% specificity.Significance: Understanding the factors associated with good or poor surgical outcomes can help choose the best candidates for SLAH. Of the variables assessed, scalp EEG findings were the most clearly associated with seizure outcomes after SLAH.

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