Survival and Cognitive Outcomes in Elderly Glioma Patients: Implications for Surgical Treatment Strategies

A new cohort analysis shows that adjuvant chemoradiotherapy and gross total resection was associated with longer overall survival in patients aged 70 and older with glioblastoma, supporting aggressive postoperative management.

This retrospective cohort included 124 patients aged ≥70 (median 74 years). Median overall survival was 8 months; the primary endpoint was overall survival from the date of index surgery. In multivariable Cox models, adjuvant therapy was associated with HR = 0.30 (95% CI 0.17–0.52) and gross total resection (GTR) versus biopsy with HR = 0.41 (95% CI 0.20–0.86). The authors also contrasted GTR with subtotal resection in sensitivity analyses. Time‑dependent modelling identified an early concentrated benefit from adjuvant therapy that attenuated by 6–12 months.

Three adjusted findings stood out: adjuvant chemoradiotherapy produced a strong early postoperative survival advantage (time‑averaged HR ≈ 0.34, with the greatest effect in month 1); GTR was associated with longer hazard‑adjusted survival versus subtotal resection or biopsy. History of smoking independently predicted higher mortality (HR ≈ 2.02), though residual confounding cannot be excluded . These directions were robust across sensitivity checks. Perioperative planning should therefore weigh the timing and magnitude of adjuvant benefit and the survival advantage of more extensive resection aainst each patient’s individual risk profile.