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Impact of frailty on survival glioblastoma, IDH-wildtype patients
Benoît Hudelist1,2, Angela Elia1,2, Alexandre Roux1,2
1Service de Neurochirurgie H?pital, GHU-Paris Psychiatrie et Neurosciences, Site Sainte Anne, 1, rue Cabanis, Paris, F-75014, France.
Journal of Neuro-Oncology
|May 19, 2024
Summary
Frailty, measured by the modified 5-item frailty index (5-mFI), significantly predicts survival in patients with newly diagnosed glioblastoma. A higher 5-mFI score indicates increased mortality risk, highlighting frailty as a key prognostic factor.
Area of Science:
- Neuro-oncology
- Geriatric Medicine
- Clinical Prognostics
Background:
- Frailty is a significant risk factor for mortality in various patient populations.
- Assessing frailty is crucial for understanding prognosis in cancer patients.
Purpose of the Study:
- To investigate the prognostic significance of frailty using the modified 5-item frailty index (5-mFI).
- To evaluate frailty as a predictor of overall survival in patients with newly diagnosed, IDH-wildtype, supratentorial glioblastoma.
Main Methods:
- Retrospective review of 694 adult patients diagnosed with glioblastoma between January 2006 and December 2021.
- Inclusion criteria included age ≥ 18, newly diagnosed IDH-wildtype supratentorial glioblastoma, and available data for 5-mFI calculation.
- Patients were categorized into frail (5-mFI ≥ 2) and non-frail (5-mFI < 2) subgroups.
Main Results:
- The median overall survival was significantly longer in the non-frail subgroup (14.3 months) compared to the frail subgroup (4.7 months) (p < 0.001).
- A 5-mFI score ≥ 2 was an independent predictor of shorter overall survival (aHR 1.31).
- Factors associated with longer survival included younger age (≤ 60 years), higher KPS score (≥ 70), unilateral tumor location, total tumor removal, and standard radiochemotherapy.
Conclusions:
- Frailty, assessed by a 5-mFI score ≥ 2, is an independent predictor of overall survival in patients with newly diagnosed IDH-wildtype supratentorial glioblastoma.
- This finding holds true even within subgroups receiving first-line oncological treatment or total removal plus adjuvant therapy.
- Frailty assessment can aid in risk stratification and treatment planning for glioblastoma patients.
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