Erschienen in:
02.05.2020 | Original Article
Molecular characteristics and clinical outcomes of elderly patients with IDH-wildtype glioblastomas: comparative study of older and younger cases in Kansai Network cohort
verfasst von:
Junya Fukai, Hideyuki Arita, Toru Umehara, Ema Yoshioka, Tomoko Shofuda, Daisuke Kanematsu, Yoshinori Kodama, Masayuki Mano, Manabu Kinoshita, Yoshiko Okita, Masahiro Nonaka, Takehiro Uda, Naohiro Tsuyuguchi, Daisuke Sakamoto, Yuji Uematsu, Naoyuki Nakao, Kanji Mori, Yonehiro Kanemura
Erschienen in:
Brain Tumor Pathology
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Ausgabe 2/2020
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Abstract
Aging 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 with IDH-wildtype GBM regarding both molecular characteristics and clinical outcomes. We collected adult cases diagnosed with IDH-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 in PTEN deletion and CDK4 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 the MGMT methylated and TERT wildtype subgroup. Elderly patients have several potential factors in poor prognosis of glioblastomas. Varying molecular profiles may explain differing rates of survival between generations.