Analysis of Prognostic Factors and Surgical Management of Elderly Patients with Low-Grade Gliomas

列线图 医学 比例危险模型 单变量 单变量分析 多元分析 胶质瘤 流行病学 放射治疗 监测、流行病学和最终结果 生存分析 多元统计 肿瘤科 内科学 接收机工作特性 外科 癌症登记处 统计 数学 癌症研究
作者
Shuaishuai Wu,Changli Wang,Ning Li,Augustine K. Ballah,Jun Lyu,Shengming Liu,Xiangyu Wang
出处
期刊:World Neurosurgery [Elsevier BV]
卷期号:176: e20-e31 被引量:2
标识
DOI:10.1016/j.wneu.2023.02.099
摘要

The number of elderly patients with low-grade glioma (LGG) is increasing, but their prognostic factors and surgical treatment are still controversial. This paper aims to investigate the prognostic factors of overall survival and cancer-specific survival in elderly patients with LGG and analyze the optimal surgical treatment strategy.Patients in the study were obtained from the Surveillance, Epidemiology, and End Results database and patients were randomized into a training and a test set (7:3). Clinical variables were analyzed by univariate and multivariate Cox regression analysis to screen for significant prognostic factors, and nomograms visualized the prognosis. In addition, survival analysis of elderly patients regarding different surgical management was also analyzed by Kaplan-Meier curves.Six prognostic factors were screened by univariate and multivariate Cox regression analysis on the training set: tumor site, laterality, histological type, the extent of surgery, radiotherapy, and chemotherapy, and all factors were visualized by nomogram. And we evaluated the accuracy of the nomogram model using consistency index, calibration plots, receiver operator characteristic curves, and decision curve analysis, showing that the nomogram has strong accuracy and applicability. We also found that gross total resection improved overall survival and cancer-specific survival in patients with LGG aged ≥65 years relative to those who did not undergo surgery (P < 0.001).Based on the Surveillance, Epidemiology, and End Results database, we created and validated prognostic nomograms for elderly patients with LGG, which can help clinicians to provide personalized treatment services and clinical decisions for their patients. More importantly, we found that older age alone should not preclude aggressive surgery for LGGs.
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