KEY TAKEAWAYS
- The study aimed to assess frailty’s prognostic role using the modified 5-item frailty index in IDH-wildtype patients with glioblastoma.
- The study concluded that in newly diagnosed IDH-wildtype supratentorial glioblastoma, frailty (5-mFI score ≥ 2) independently predicted OS.
Benoît Hudelist and the team investigated how frailty, assessed with the modified 5-item frailty index (5-mFI), impacts mortality risk in individuals with newly diagnosed IDH-wildtype supratentorial glioblastoma, a form of brain cancer.
Records of patients surgically treated at a sole neurosurgical institution during the standard radiochemotherapy era (January 2006 – December 2021) were retrospectively reviewed. Inclusion criteria comprised individuals aged 18 and above, newly diagnosed with glioblastoma, IDH-wildtype, and located supratentorially, with available data to evaluate the 5-item modified frailty index (5-mFI).
The results revealed that among the 694 adult patients included, those in the non-frail subgroup (5-mFI < 2, n = 538) had a median overall survival of 14.3 months (95%CI 12.5–16.0), which was longer than that of patients in the frail subgroup (5-mFI ≥ 2, n = 156) with a median of 4.7 months (95%CI 4.0-6.5 months; P< 0.001).
A 5-mFI ≥ 2 aHR 1.31; 95%CI 1.07–1.61; P= 0.009) independently predicted shorter overall survival. Other factors associated with longer overall survival included age ≤ 60 years (aHR 0.78; 95%CI 0.66–0.93; P= 0.007), KPS score ≥ 70 (aHR 0.71; 95%CI 0.58–0.87; P= 0.001), unilateral location (aHR 0.67; 95%CI 0.52–0.87; P= 0.002), total removal (aHR 0.54; 95%CI 0.44–0.64; P< 0.0001), and standard radiochemotherapy protocol (aHR 0.32; 95%CI 0.26–0.38; P< 0.0001).
Frailty remained an independent predictor of overall survival within the subgroup of patients who underwent first-line oncological treatment after surgery (n = 549) and within the subgroup of patients who underwent total removal plus adjuvant standard radiochemotherapy (n= 209).
The study concluded that in patients newly diagnosed with IDH-wildtype supratentorial glioblastoma and treated during the standard combined radiochemotherapy era, frailty, as defined by a 5-mFI score ≥ 2, independently predicted overall survival.
No funding was provided.
Source: https://link.springer.com/article/10.1007/s11060-024-04699-y
Hudelist, B., Elia, A., Roux, A., et al. (2024). “Impact of frailty on survival glioblastoma, IDH-wildtype patients.” J Neurooncol. https://doi.org/10.1007/s11060-024-04699-y
