Evidence map›Paper›PMID 41661370›Full record

ArticleJournal of neuro-oncology2026

Maximal resection improves survival in MGMT methylated very elderly glioblastoma patients.

Dragan Jankovic, Santhosh G Thavarajasingam, Daniel Scurtu, Manuel V Baby, Andreas Kramer, Jonathan Weller, Veit Stöcklein, Marc A Brockmann, Clemens Sommer, Petra Leukel and 5 more

Abstract read
In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Dragan JankovicDepartment of Neurosurgery, University Medical Center Mainz, Mainz, Germany. dragan.jankovic@med.uni-muenchen.de.
Santhosh G ThavarajasingamDepartment of Neurosurgery, University Medical Center Mainz, Mainz, Germany.
Daniel ScurtuDepartment of Neurosurgery, University Medical Center Mainz, Mainz, Germany.
Manuel V BabyImperial Brain & Spine Initiative, Imperial College London, London, UK.
Andreas KramerDepartment of Neurosurgery, University Medical Center Mainz, Mainz, Germany.
Jonathan WellerDepartment of Neurosurgery, LMU University Hospital, 81377, Munich, Germany.
Veit StöckleinDepartment of Neurosurgery, LMU University Hospital, 81377, Munich, Germany.
Marc A BrockmannDepartment of Neuroradiology, University Medical Center Mainz, Mainz, Germany.
Clemens SommerInstitute of Neuropathology, University Medical Center Mainz, Mainz, Germany.
Petra LeukelInstitute of Neuropathology, University Medical Center Mainz, Mainz, Germany.
Marcus StockingerDepartment of Radiooncology and Radiotherapy, University Medical Center Mainz, Mainz, Germany.
Harald KrenzlinDepartment of Neurosurgery, University Medical Center Mainz, Mainz, Germany.
Naureen KericDepartment of Neurosurgery, University Medical Center Mainz, Mainz, Germany.
Florian RingelDepartment of Neurosurgery, University Medical Center Mainz, Mainz, Germany.
Darius KalasauskasDepartment of Neurosurgery, University Medical Center Mainz, Mainz, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlioblastoma is the most aggressive primary tumor of the central nervous system, with particularly poor prognosis in elderly patients. Individuals aged ≥ 75 years remain underrepresented in clinical trials, resulting in limited evidence to guide treatment decisions. This study aimed to analyze treatment patterns and survival outcomes in patients aged 75 years or older with newly diagnosed IDH-wildtype glioblastoma.

methodsWe conducted a single-center retrospective study of 108 consecutive patients aged ≥ 75 years who underwent surgical intervention between 2016 and 2022. Patients were stratified by age group (75–79 vs. ≥80 years), surgical modality (biopsy vs. resection), extent of resection (maximal vs. submaximal), MGMT promoter methylation status, and adjuvant therapy. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan–Meier analysis and Cox proportional hazards models.

resultsThe median age was 79 years, and 46.3% of patients were female. Biopsy alone was performed in 33.3% of patients, while 60.8% underwent surgical resection. Resection significantly improved OS compared with biopsy (p = 0.0047), with maximal resection providing superior OS compared with submaximal resection (p = 0.00016). The benefit of maximal resection was most pronounced in patients aged 75–79 years and in those with MGMT-methylated tumors. Among adjuvant treatments, radiochemotherapy conferred the strongest survival advantage (HR 0.174, 95% CI 0.086–0.355, p < 0.001).

conclusionsMaximal resection significantly improves survival in glioblastoma patients aged ≥ 75 years, particularly those with MGMT-methylated tumors, and should be considered even in selected patients aged ≥ 80 years. These findings underscore the importance of individualized treatment strategies and support the feasibility of aggressive surgical management in very elderly patients with favorable clinical status.

Indexed as

Brain NeoplasmsDNA MethylationDNA Modification MethylasesDNA Repair EnzymesGlioblastomaNeurosurgical ProceduresTumor Suppressor ProteinsAgedAged, 80 and overFemaleFollow-Up StudiesHumansMalePrognosisRetrospective StudiesSurvival RateDNA Modification MethylasesDNA Repair EnzymesMGMT protein, humanTumor Suppressor ProteinsElderly patientsGlioblastomaMGMT promoter methylationSurgical resectionSurvival

Identifiers

PMID41661370
PMCPMC12886232

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.