Molecular characteristics and clinical outcomes of elderly patients with IDH -wildtype glioblastomas: comparative study of older and younger cases in Kansai Network cohort

AbstractAging is a known negative prognostic factor in glioblastomas (GBM). Whether particular genetic backgrounds are a factor in poor outcomes of elderly patients with GBM warrants investigation. We aim to elucidate any differences between older and younger adult patients withIDH-wildtype GBM regarding both molecular characteristics and clinical outcomes. We collected adult cases diagnosed withIDH-wildtype GBM from the Kansai Network. Clinical and pathological characteristics were analyzed retrospectively and compared between older ( ≥ 70 years) and younger (≤ 50 years) cases. Included were 92 older vs. 33 younger cases. The older group included more patients with preoperative Karnofsky performance status score <  70 and had a shorter survival time than the younger group.MGMT promoter was methylated more frequently in the older group.TERT promoter mutation was more common in the older group. There were significant differences in DNA copy-number alteration profiles between age groups inPTEN deletion andCDK4 amplification/gain. In the older group, no molecular markers were identified, but surgical resection was an independent prognostic factor. Age-specific survival difference was significant in theMGMT methylated andTERT wildtype subgroup. Elderly patients have several potential factors in poor prognosis of glioblastomas. Varying molecular profiles may explain differing rates of survival between generations.
Source: Brain Tumor Pathology - Category: Neurology Source Type: research