Functional Outcomes After Reoperation for Recurrent Glioma: A Systematic Review and Meta-Analysis of Karnofsky...

Area of Science:

• Neurosurgery
• Oncology
• Quality of Life Research

Background:

• Gliomas are common adult primary brain tumors with variable recurrence rates.
• Reoperation is a key strategy for managing glioma recurrence.
• The impact of reoperation on functional status and quality of life is not well-defined.

Purpose of the Study:

• To systematically review evidence on postoperative functional outcomes after glioma reoperation.
• To summarize health-related quality of life (HRQoL) reporting in the reoperation literature.

Main Methods:

• Systematic search of PubMed and Google Scholar (1336 articles retrieved).
• 15 studies (1934 patients) met inclusion criteria, using validated functional or HRQoL instruments.
• Meta-analysis of Karnofsky Performance Status (KPS); descriptive summary of HRQoL measures due to heterogeneity.

Main Results:

• Random-effects model showed no significant overall change in KPS after reoperation (+0.16 KPS).
• High heterogeneity (I² ≈ 48%) and wide prediction intervals (-14.1 to +14.4) indicate significant variability in outcomes.
• Sensitivity analyses did not materially alter results after excluding an outlier study.

Conclusions:

• Glioma reoperation is not consistently associated with functional decline (KPS), despite significant outcome variability.
• Health-related quality of life (HRQoL) reporting is sparse and inconsistent.
• Prospective, multicenter studies with standardized HRQoL instruments are needed to clarify post-reoperation quality-of-life trajectories.