# Brain Tumor Care in Relation to Patient Age—An Observational Study Between Years 2016 and 2022 in a Nationwide Cohort in Germany

## TL;DR

This study examines brain tumor care trends in Germany from 2016 to 2022, showing similar improvements in care for non-elderly and elderly patients, except for those aged 75–84.

## Contribution

The study provides real-world evidence on longitudinal trends in brain tumor care across age groups in Germany.

## Key findings

- Both non-elderly and elderly patients showed improved comorbidity and frailty profiles over time.
- Rates of brain tumor resection increased for both non-elderly and elderly patients.
- Patients aged 75–84 years did not follow the observed trends in care improvements.

## Abstract

As societies continue to age, brain tumors increasingly affect older patients. Still, large-scale real-world evidence on the longitudinal evolution of the relationship between age and neuro-oncology is scarce. We used data from a nationwide hospital network in Germany to examine trends in brain tumor care for non-elderly vs. elderly patients between years 2016 and 2022. Among the 20,005 subjects included, trends in brain tumor care behaved quite similarly between non-elderly and elderly patients, given that, over time, both groups showed improvements in comorbidity and frailty profiles as well as an increase in rates of brain tumor resection. Only the specific cluster of those aged 75–84 years did not follow any of those trends. Our findings suggest similar trends in brain tumor care between non-elderly and elderly patients. They offer a rare glimpse into real-world dynamics of current neuro-oncological patient cohorts.

As societies continue to age, brain tumors increasingly affect older patients. Still, large-scale evidence on whether the relationship between age and brain tumor has been evolving over time is scarce. We examined longitudinal trends among different age groups of patients with brain tumors at 78 German hospitals. Two time periods were compared as follows: phase 1 (1 January 2016–31 December 2019; pre-pandemic) and phase 2 (1 January 2020–31 December 2022; pandemic). Patients were categorized as non-elderly (<65 years) or elderly (≥65 years), and according to 10-year age brackets. The clinical condition was quantified using the Elixhauser Comorbidity Index (ECI) and the Hospital Frailty Risk Score (HFRS). Among the 20,005 patients included, changes in characteristics of non-elderly/elderly patients over time behaved similarly, with improvements in ECI (19.3 to 18.4/15.2 to 14.3; each p < 0.01) and HFRS (2.1 to 1.6/4.7 to 4.1; each p < 0.01), and increases in rates of brain tumor resection (26.1% to 31.8%/22.7% to 27.8%; each p < 0.01). Only patients aged 75–84 years did not follow any of those trends. Over the examined 7-year period, general trends in brain tumor care in elderly subjects resembled those observed in non-elderly patients, except for those aged 75–84 years.