Feasibility, Safety and Impact on Overall Survival of Awake Resection for Newly Diagnosed Supratentorial IDH-Wildtype Glioblastomas in Adults
| العنوان: | Feasibility, Safety and Impact on Overall Survival of Awake Resection for Newly Diagnosed Supratentorial IDH-Wildtype Glioblastomas in Adults |
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| المؤلفون: | Jean-Baptiste Pelletier, Bénédicte Trancart, Catherine Oppenheim, Alessandro Moiraghi, Edouard Dezamis, Alexandre Roux, Emmanuèle Lechapt, Marwan Baroud, Fabrice Chrétien, Chiara Benevello, Eduardo Parraga, Sophie Peeters, Pascale Varlet, Marc Zanello, Johan Pallud |
| المصدر: | Cancers Volume 13 Issue 12 Cancers, Vol 13, Iss 2911, p 2911 (2021) Brain and Spine, Vol 1, Iss, Pp 100469-(2021) |
| بيانات النشر: | MDPI AG, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Cancer Research, medicine.medical_specialty, Newly diagnosed, IDH-wildtype, survival, Article, Resection, 03 medical and health sciences, 0302 clinical medicine, Biopsy, medicine, Overall survival, RC346-429, Awake surgery, RC254-282, medicine.diagnostic_test, business.industry, glioblastoma, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, extent of resection, Surgery, awake surgery, Oncology, 030220 oncology & carcinogenesis, Cohort, Neurology. Diseases of the nervous system, Neurosurgery, business, 030217 neurology & neurosurgery, Glioblastoma |
| الوصف: | Background: Although awake resection using intraoperative cortico-subcortical functional brain mapping is the benchmark technique for diffuse gliomas within eloquent brain areas, it is still rarely proposed for IDH-wildtype glioblastomas. We have assessed the feasibility, safety, and efficacy of awake resection for IDH-wildtype glioblastomas. Methods: Observational single-institution cohort (2012–2018) of 453 adult patients harboring supratentorial IDH-wildtype glioblastomas who benefited from awake resection, from asleep resection, or from a biopsy. Case matching (1:1) criteria between the awake group and asleep group: gender, age, RTOG-RPA class, tumor side, location and volume and neurosurgeon experience. Results: In patients in the awake resection subgroup (n = 42), supratotal resections were more frequent (21.4% vs. 3.1%, p < 0.0001) while partial resections were less frequent (21.4% vs. 40.1%, p < 0.0001) compared to the asleep (n = 222) resection subgroup. In multivariable analyses, postoperative standard radiochemistry (aHR = 0.04, p < 0.0001), supratotal resection (aHR = 0.27, p = 0.0021), total resection (aHR = 0.43, p < 0.0001), KPS score > 70 (HR = 0.66, p = 0.0013), MGMT promoter methylation (HR = 0.55, p = 0.0031), and awake surgery (HR = 0.54, p = 0.0156) were independent predictors of overall survival. After case matching, a longer overall survival was found for awake resection (HR = 0.47, p = 0.0103). Conclusions: Awake resection is safe, allows larger resections than asleep surgery, and positively impacts overall survival of IDH-wildtype glioblastoma in selected adult patients. |
| وصف الملف: | application/pdf |
| تدمد: | 2072-6694 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d84992f1be2cbd2f55757c210f17e7baTest https://doi.org/10.3390/cancers13122911Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....d84992f1be2cbd2f55757c210f17e7ba |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20726694 |
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