Aging is a known negative prognostic factor in glioblastomas (GBM). Whether particular genetic backgrounds are a factor in poor outcomes of elderly patients with GBM warrants investigation. We aim to elucidate any differences between older and younger adult patients with IDH-wildtype GBM regarding both molecular characteristics and clinical outcomes. We collected adult cases diagnosed with IDH-wildtype GBM from the Kansai Network. Clinical and pathological characteristics were analyzed retrospectively and compared between older (≥ 70 years) and younger (≤ 50 years) cases. Included were 92 older vs. 33 younger cases. The older group included more patients with preoperative Karnofsky performance status score < 70 and had a shorter survival time than the younger group. MGMT promoter was methylated more frequently in the older group. TERT promoter mutation was more common in the older group. There were significant differences in DNA copy-number alteration profiles between age groups in PTEN deletion and CDK4 amplification/gain. In the older group, no molecular markers were identified, but surgical resection was an independent prognostic factor. Age-specific survival difference was significant in the MGMT methylated and TERT wildtype subgroup. Elderly patients have several potential factors in poor prognosis of glioblastomas. Varying molecular profiles may explain differing rates of survival between generations.

中文翻译：

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老年IDH野生型胶质母细胞瘤患者的分子特征和临床结局：关西网络队列中老年和年轻病例的比较研究。

衰老是胶质母细胞瘤（GBM）中已知的阴性预后因素。是否有特定的遗传背景是导致GBM老年患者预后不良的因素，有待调查。我们旨在阐明IDH野生型GBM的老年人和年轻人患者在分子特征和临床结局方面的任何差异。我们从关西网络收集了被诊断为IDH野生型GBM的成人病例。回顾性分析临床和病理学特征，并比较老年（≥70岁）和年轻（≤50岁）病例。其中包括92例老年患者，而33例年轻患者。老年组包括更多术前Karnofsky行为状态评分<70的患者，并且生存时间比年轻组短。MGMT在老年组中，启动子甲基化的频率更高。TERT启动子突变在较年长的人群中更为常见。在PTEN缺失和CDK4扩增/获得的年龄组之间，DNA拷贝数改变谱存在显着差异。在老年组中，未发现分子标记，但手术切除是独立的预后因素。MGMT甲基化和TERT野生型亚组的年龄特异性生存差异显着。老年患者胶质母细胞瘤预后不良的几个潜在因素。不同的分子谱可以解释几代人之间不同的存活率。