ORIGINAL RESEARCH article
Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1657867
Age is not a significant predictor of survival in patients with IDH-wildtype glioblastoma that undergo gross total resection and complete adjuvant chemoradiation
Provisionally accepted
Jeffrey Warren Cozzens1*
Noah B. Drewes1
Kristin Delfino1Kayla L. Chin1Devin V. Amin1Barbara C. Lokaitis1José A. Espinosa1Breck A. Jones1Leslie J. Acakpo-Satchivi2Hayan Dayoub2M. Bruce Frankel1Edem Agamah1
Krishna Rao1C. Matthew Bradbury2
John Gao3- 1Southern Illinois University School of Medicine, Springfield, United States
- 2Springfield Clinic LLP, Springfield, United States
- 3Springfield Memorial Hospital, Springfield, United States
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Older age is often cited as a negative prognostic factor for individuals with glioblastoma, but it is unclear if this is true when other prognostic factors are equalized. METHODS: This study is an observational, single-center retrospective analysis of data from consecutive individuals with histologically identified high-grade glioma prospectively accumulated for a registry of all neurosurgical operations in our region from 2010 to 2024 (15 years). Data concerning histology, survival, IDH mutations, MGMT methylation status, extent of resection, frailty (measured by m-Fi-5 index) and subsequent adjuvant treatment (radiation and chemotherapy) were all recorded. Statistical analysis was performed on selected groups with Kaplan-Meier survival analysis, Student's t-test and multivariable Cox proportional hazards regression. RESULTS: There were 270 individuals who underwent a neurosurgical procedure resulting in a histopathological diagnosis of glioblastoma. The data from a select group of 91 individuals were examined where all individuals had tumors with IDH-wildtype, gross total resection, and treated with chemoradiation. When univariately assessing for the impact of age on survival, no significant association was found (p=0.5380). After adjusting for MGMT methylation status and frailty, age remained insignificantly associated with overall survival (p=0.4009). CONCLUSIONS: Age does not seem to be a factor in overall survival for glioblastoma when all the other prognostic factors are equalized. The idea that younger age is a positive prognostic factor is probably the result of more frequent IDH-mutant tumors in younger patients, increased incidence of frailty in older patients and the unwillingness of healthcare providers and patients/families to aggressively treat older patients.
Keywords: Glioblastoma, age, prognosis, Frailty, Survival
Received: 01 Jul 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 Cozzens, Drewes, Delfino, Chin, Amin, Lokaitis, Espinosa, Jones, Acakpo-Satchivi, Dayoub, Frankel, Agamah, Rao, Bradbury and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jeffrey Warren Cozzens, Southern Illinois University School of Medicine, Springfield, United States
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