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Supratotal Resection: An Emerging Concept of Glioblastoma Multiforme Surgery-Systematic Review And Meta-Analysis
Peer Asad Aziz1, Salma Farrukh Memon1, Mubarak Hussain1
1Department of Neurosurgery, Liaquat University of Medical Health Sciences, Jamshoro, Pakistan.
World Neurosurgery
|July 14, 2023
Summary
Supratotal resection (SpTR) offers improved survival outcomes for glioblastoma (GBM) patients. This advanced surgical technique for grade IV astrocytoma significantly enhances both overall survival and progression-free survival compared to standard methods.
Area of Science:
- Neurosurgery
- Oncology
- Medical Imaging
Background:
- Glioblastoma (GBM), a grade IV astrocytoma, is an aggressive and debilitating primary brain tumor.
- Supratotal resection (SpTR) represents an advanced surgical strategy aiming for more extensive tumor removal in glioma treatment.
Approach:
- A comprehensive, language-independent literature search was conducted across PubMed, Scopus, and Cochrane CENTRAL databases.
- The search identified studies published up to August 2022, focusing on patients who underwent SpTR.
Key Points:
- A meta-analysis included 13 retrospective studies comparing SpTR with other surgical modalities.
- SpTR demonstrated a statistically significant increase in overall survival (HR 0.77, P < 0.01) and progression-free survival (HR 0.2, P = 0.002).
- High heterogeneity (I² = 96% for OS, I² = 88% for PFS) was noted across the included studies.
Conclusions:
- Supratotal resection (SpTR) is associated with superior overall survival and progression-free survival (PFS) in glioblastoma patients.
- SpTR shows improved outcomes compared to conventional glioblastoma surgeries such as gross total resection (GTR) or subtotal resection (SubTR).
- The findings support SpTR as a potentially more effective surgical approach for managing glioblastoma.
