Post-Doctoral Neurosurgery Research Fellow Johns Hopkins University Johns Hopkins University School of Medicine Baltimore, MD, US
Disclosure(s):
Abdel-Hameed Al-Mistarehi, MD: No financial relationships to disclose
Introduction: Hemangioblastomas are benign central nervous system tumors. Due to its low incidence in the elderly population, the clinical features and treatment outcomes of geriatric patients remain limited. This study aims to investigate the age-related differences in treatment and outcome and identify potential risk factors.
Methods: Patients with hemangioblastoma were identified from the National Cancer Database (NCDB) between 2004 and 2017. The cohort was divided into four age groups: 65-69, 70-74, and 75-79, above 80. Univariate analyses were conducted for comparative study. Kaplan-Meier survival analysis was used to access overall survival (OS). Multivariate Cox regression was used for risk factor study.
Results: A total of 138 geriatric hemangioblastoma patients were identified and divided into four age groups: 65-69 (56 patients), 70-74 (30), 75-79 (29), and above 80 (23). Sex and racial distribution was similar across all groups. Although the Charlson-Deyo Comorbidity Class (CDCC) score showed no significant difference (p=0.881), higher comorbidity scores (≥2) were more common in the 75-79 (17.2%) and above 80 (17.4%) groups. Medicare was the primary insurance that covered more than 70% of patients in all groups (p=0.547). Treatments were consistent in all groups, with gross total resection (GTR) being the mainstay, followed by GTR with radiation (p=0.547). The 5-year mortality rate was significantly higher in the 75-79 (55.2%) and above 80 (52.2%) groups compared to the 70-74 (33.3%) and 65-69 (14.3%) groups (p < 0.001). Multivariate Cox regression showed remarkably elevated mortality risk for patients aged 75-79 (HR:8.52, p< 0.001) and above 80 (HR : 5.47, p< 0.001). GTR alone or with radiation was associated with reduced risk (HR:0.22, p=0.022; HR:0.06, p=0.009, respectively)
Conclusion : The study highlights that hemangioblastoma patients at an advanced age were associated with significantly increased mortality risk, which pinpoints the need for treatments that adequately address the aging-related factors to improve the outcome of this vulnerable population.
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