Characteristics and patterns of care of high-grade IDH-mutant gliomas in elderly patients: A French POLA network study

Abstract

Abstract Background The characteristics of elderly patients with IDH-mutant (IDHm) high-grade gliomas (HGG) remain to be described. This study aims to describe characteristics and patterns of care of elderly patients with IDHm HGG included in the French POLA network dedicated to HGG. Methods The characteristics and patterns of care of elderly (≥70 years) patients IDHm HGG were compared to those of younger patients ( Results Out of the 1433 HGG patients included, 119 (8.3%) occurred in elderly patients. Histology consisted of 1p/19q codeleted anaplastic oligodendroglioma (71.8%), anaplastic IDHm astrocytomas (12.8%) and IDHm glioblastoma (15.4%). Median age at diagnosis was 74 years (70.2-87.1), median Karnofsky Performans Status (KPS) was 80 (50-100). Treatments consisted of a wait and scan policy (7.7%), radiotherapy (RT) alone (7.7%), chemotherapy (CT) alone (41%), RT-CT (RT-TMZ: 25.6%, RT-PCV: 15.4%) or palliative care (2.6%). The clinical, radiological and histological presentations of elderly patients IDHm HGG were different from those of elderly patients IDHwt HGG. Compared to elderly patients IDHwt HGG, elderly patients IDHm were less frequently associated with cognitive impairment (p\xa0=\xa00.045), contrast enhancement (p\xa0=\xa00.01) and had a lower proliferative index (Ki67) (p\xa0=\xa00.005). In contrast, there was no difference regarding clinical, radiological and histological presentations of elderly and younger patients IDHm HGG but their management was different. Elderly patients IDHm less frequently underwent gross total resection (p\xa0=\xa00.002) and radiotherapy (p\xa0 Conclusions IDHm HGG in elderly show prolonged survival. However, their poorer outcome compared to younger IDHm gliomas may results from patient or tumor characteristics or from under-treatment, suggesting a role for geriatric assessment. Legal entity responsible for the study French POLA network. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.