Abstract: Background Glioblastoma multiforme (GBM) is the most common and malignant primary brain tumour in
adults. Due to the ageing of the population, diagnosis in the elderly is becoming more common. The aim of
this study was to analyse different combinations of treatments and to identify preoperative factors, including
O6-methylguanine-DNA methyltransferase status, that may be associated with decreased survival among
patients older than 70 years. Methods and materials We retrospectively included all patients over 70 years
of age, who underwent surgery at the Department of Neurosurgery (HUCA and HUMV) and were diagnosed
of GBM by pathological criteria from January 2007 to September 2014. Results Eighty-one patients were
analysed, whose mean age was 75 (SD 4) and 48 were male. Karnofsky performance status (KPS) was over 70
in 61 patients and 38.3% presented with motor deficit. Sixty-three patients underwent resection, and 18 had
only a diagnostic biopsy. The complication rate was 17.28% and mortality rate was 7.4%. Survival was
increased in patients who received radiotherapy (n¼41) or additional chemotherapy (n¼26) (p50.001).
KPS570 was an independent factor associated with low-rate survival. Patients with optimal treatment had a
median survival of 8 months compared to patients with suboptimal treatment who had a median survival of
4 months (p50.001). Conclusions This study suggests that KPS is the most important preoperative
prognostic factor. Maximal safe resection followed by radical radiotherapy and temozolomide might be the
optimal treatment of choice since glioblastoma-diagnosed patients over 70 years of age showed a
statistically significant survival benefit.
