Browsing by Author "Lindqvist, Arvid"

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    Diffuse low-grade glioma and anaplastic glioma in the elderly
    (2019-12-30) Lindqvist, Arvid; University of Gothenburg / Institute of Medicine; Göteborgs universitet / Institutionen för medicin
    Abstract: Diffuse low-grade glioma and anaplastic glioma in the elderly Introduction: Lower-grade glioma (WHO grade II and III) are malignant brain tumours that grow infiltratively and eventually transform into glioblastoma (grade IV) resulting in death. A negative prognostic marker following lower-grade glioma diagnosis is old age, but its covariance with other known prognostic factors and tumour biology remains elusive. In addition, impaired outcome following glioma diagnosis in the elderly may also be due to “ageism”, where older patients receive suboptimal care. Objective: Study differences in tumour characteristics, symptomatology, patterns of care and outcome in older and younger patients with lower-grade glioma. Methods: We studied 69 patients (>50 years, older cohort) and 90 patients (18-50 years, younger cohort) with histopathological diagnosis of lower-grade glioma between 2010-2016 at Sahlgrenska University Hospital. Results: Older patients presented more often with cognitive deficits (21.7% vs 6.7 %, p= 0.005) and focal deficits (37.7% vs 22.2%, p=0.033). They were more often biopsied and less often underwent resection compared to young patients (37.7% vs 14.4%, p=0.001) and their disease-specific survival were significantly impaired (p<0.001). Our preliminary findings suggests differences in the patterns of underlying mutations between the groups, with more IDH-wildtype lower-grade gliomas in the older group (p=0.011). Conclusion: The impaired survival in elderly patients were probable due to a combination of negative prognostic factors, but where tumour biology presumably were of major importance.