April 2026

NEUROSCIENCES

MAXIMAL SAFE RESECTION SIGNIFICANTLY EXTENDS SURVIVAL IN OLDER GLIOBLASTOMA PATIENTS

A new Northwestern Medicine study, published in the Journal of Neuro-Oncology, demonstrates that maximal safe surgical resection, when integrated with contemporary multimodal therapy, can significantly extend survival while helping preserve functional independence in elderly patients with glioblastoma (GBM).
 
This retrospective analysis of 82 patients aged 70 and older, treated between 2016 and 2024, represents one of the largest and most methodologically consistent single-center cohorts of elderly GBM patients undergoing resection.

Key Highlights:
 
Significant Survival Advantage With Resection
The study found that maximal safe resection nearly tripled median survival compared to biopsy alone:
  • 8.8 months after resection
  • 2.7 months after biopsy
Even when adjusted for tumor biology (MGMT status), comorbidity burden (ASA), radiation, and temozolomide use, resection remained independently associated with longer survival (HR 0.34, p < 0.001).

Benefits Extend to Patients Aged 80+
In one of the few analyses focusing specifically on octogenarians:
  • Resection improved median overall survival from 3.0 to 6.5 months.
  • Resection remained beneficial after multivariate adjustment (HR 0.28, p = 0.018).
This demonstrates that age alone should not preclude surgical intervention when patients are appropriately selected.

Multimodal Therapy Is Essential
The survival benefit of resection was most pronounced in patients who received:
  • Radiation therapy (RTx)
  • Temozolomide (TMZ)
Patients who did not receive adjuvant therapy did not experience a significant benefit from surgery, underscoring the importance of coordinated, multidisciplinary care.

Functional Independence Maintained
Contrary to common perceptions about post-operative decline in the elderly, the majority of patients maintained good performance status:
  • 63–71% had ECOG 0–1 at 3, 6, and 12 months
These outcomes held true even among octogenarians, supporting the view that surgery can be both life-extending and function-preserving in carefully selected individuals.

Pathway to Long-Term Survival
Nine patients survived more than two years, all of whom:
  • Underwent gross total resection
  • Completed full chemoradiation and adjuvant TMZ
  • Had strong pre-operative functional status
These results show that meaningful, long-term survival is achievable even in older adults with GBM.
 
Given the retrospective design and limited subgroup sizes, however, these findings should be considered exploratory and warrant validation in larger cohorts.
 
Read the full study >
Osaama H. Khan, MD, MS, Clinical Assistant Professor of Neurological Surgery at Northwestern Medicine, was corresponding author of the study published in the Journal of Neuro-Oncology.

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