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Surgery for Recurrent Glioblastoma Multiforme: A Retrospective Case Control Study
Mathew R Voisin1, Jeffrey A Zuccato1, Justin Z Wang1
1Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
World Neurosurgery
|July 23, 2022
Summary
Repeat surgery for recurrent glioblastoma multiforme (GBM) significantly improves survival. Patients with a longer time to tumor recurrence, over 6 months, benefit the most from this intervention.
Area of Science:
- Neuro-oncology
- Surgical Oncology
- Clinical Neuroscience
Background:
- The role of repeat surgery for recurrent glioblastoma multiforme (GBM) is debated.
- Identifying prognostic factors for repeat surgery in GBM is crucial for patient selection.
Purpose of the Study:
- To determine which patients with recurrent GBM benefit most from repeat surgery.
- To analyze the impact of time to tumor recurrence as a prognostic factor in recurrent GBM.
Main Methods:
- A 10-year case-control study of adult patients with isocitrate dehydrogenase wildtype GBM.
- Matching patients who received repeat surgery for recurrent GBM with those who received medical therapy.
- Analyzing overall survival and post-recurrence survival based on treatment and time to recurrence.
Main Results:
- The surgery cohort (87 patients) demonstrated significantly longer overall survival (P=0.0003) and post-recurrence survival (P=0.001) compared to the nonsurgery cohort (87 patients).
- Patients with a time to tumor recurrence greater than 6 months showed significantly increased survival (P < 0.0001).
- Multivariate analysis confirmed surgery for recurrent GBM was independently significant (P < 0.0001).
Conclusions:
- Surgery for recurrent GBM improves survival, irrespective of age, Karnofsky Performance Scale, and time to tumor recurrence.
- Patients experiencing recurrence after more than 6 months gain the most benefit from repeat surgical intervention.
