gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Improvement of functional outcome after radical surgery in glioblastoma patients: The efficacy of a navigation-guided fence-post procedure and neurophysiological monitoring

Meeting Abstract

  • corresponding author K. Kajiwara - Department of Neurosurgery, Yamaguchi University School of Medicine
  • K. Yoshikawa - Department of Neurosurgery, Yamaguchi University School of Medicine
  • J. Morioka - Department of Neurosurgery, Yamaguchi University School of Medicine
  • M. Fujii - Department of Neurosurgery, Yamaguchi University School of Medicine
  • N. Tanaka - Department of Neurosurgery, Yamaguchi University School of Medicine
  • H. Fujisawa - Department of Neurosurgery, Yamaguchi University School of Medicine
  • S. Kato - Department of Neurosurgery, Yamaguchi University School of Medicine
  • S. Nomura - Department of Neurosurgery, Yamaguchi University School of Medicine
  • M. Suzuki - Department of Neurosurgery, Yamaguchi University School of Medicine

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 08.112

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc329.shtml

Published: May 8, 2006

© 2006 Kajiwara et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: This retrospective study investigated the functional outcomes of patient with glioblastoma receiving radical surgery before and after the adoption of the navigation-guided fence-post (NGFP) procedure and neurophysiological monitoring.

Methods: We investigated the functional outcomes of 42 glioblastoma patients receiving radical surgery in our institute between 1980 and 2005. Of the 42 patients, 18 patients from 1980 to 1996 (1st term) underwent radical surgery without navigation system guidance, NGFP, or neurophysiological monitoring; 11 patients from 1997 to 2002 (2nd term) underwent surgery with simple navigation system guidance but without NGFP procedure or neurophysiological monitoring, and 13 patients from 2003 to 2005 (3rd term) underwent surgery with the NGFP procedure and neurophysiological monitoring as appropriate. There were no significance differences between any of the three term groups in age, gender, preoperative KPS score, or “surgical staging for glioma” according to the difficulty of surgery.

Results: The rates of 95% or greater volume reduction in each term were 38.9, 54.5 and 76.9%. The rates of morbidity were 38.9, 18.1% and 0%. The change in KPS scores (delta KPS) before and after the perioperative period in each term were –16.1±6.6SEM, -9.0±5.8SEM and +8.5±3.7SEM, respectively. The delta KPS in the 3rd term was significantly better than those of 1st and 2nd terms (p<0.01, Kruskal-Wallis rank test). The rate of patients who were discharged to home and who resumed daily useful life without assistance was 38.9, 63.6 and 84.6% in each term, respectively. The mean survival times in each term were 9.9, 14.0 and 16.8 months.

Conclusions: The introduction of the NGFP procedure and neurophysiological monitoring in glioblastoma radical surgery improved the functional outcome of patients.