التفاصيل البيبلوغرافية
| العنوان: |
Multiple surgical resections for progressive IDH wildtype glioblastoma—is it beneficial? |
| المؤلفون: |
Honeyman, Susan Isabel, Owen, William J., Mier, Juan, Marks, Katya, Dassanyake, Sohani N., Wood, Matthew J., Fairhead, Rory, Martinez-Soler, Pablo, Jasem, Hussain, Yarlagadda, Ananya, Roach, Joy R., Boukas, Alexandros, Stacey, Richard, Apostolopoulos, Vasileios, Plaha, Puneet |
| المصدر: |
Acta Neurochirurgica; 3/15/2024, Vol. 166 Issue 1, p1-14, 14p |
| مصطلحات موضوعية: |
SURGICAL excision, DIFFUSION tensor imaging, GLIOBLASTOMA multiforme, TUMOR surgery, OVERALL survival |
| مستخلص: |
Purpose: The role of repeat resection for recurrent glioblastoma (rGB) remains equivocal. This study aims to assess the overall survival and complications rates of single or repeat resection for rGB. Methods: A single-centre retrospective review of all patients with IDH-wildtype glioblastoma managed surgically, between January 2014 and January 2022, was carried out. Patient survival and factors influencing prognosis were analysed, using Kaplan–Meier and Cox regression methods. Results: Four hundred thirty-two patients were included, of whom 329 underwent single resection, 83 had two resections and 20 patients underwent three resections. Median OS (mOS) in the cohort who underwent a single operation was 13.7 months (95% CI: 12.7–14.7 months). The mOS was observed to be extended in patients who underwent second or third-time resection, at 22.9 months and 44.7 months respectively (p < 0.001). On second operation achieving > 95% resection or residual tumour volume of < 2.25 cc was significantly associated with prolonged survival. There was no significant difference in overall complication rates between primary versus second (p = 0.973) or third-time resections (p = 0.312). The use of diffusion tensor imaging (DTI) guided resection was associated with reduced post-operative neurological deficit (RR 0.37, p = 0.002), as was use of intraoperative ultrasound (iUSS) (RR 0.45, p = 0.04). Conclusions: This study demonstrates potential prolongation of survival for rGB patients undergoing repeat resection, without significant increase in complication rates with repeat resections. Achieving a more complete repeat resection improved survival. Moreover, the use of intraoperative imaging adjuncts can maximise tumour resection, whilst minimising the risk of neurological deficit. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
