Artikel
Clinical results of surgical resection of recurrent glioblastomas – a retrospective study of the Section of Neurooncology of the DGNC
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Autoren
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F. Ringel
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München
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H. Pape
- Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München
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M. Simon
- Neurochirurgische Klinik und Poliklinik, Rheinische Friedrich-Wilhelms-Universität Bonn
| Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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Objective: While resection of recurrent glioblastoma (GB) has become clinical routine at many centers recent studies failed to show a benefit of repeat surgery with respect to survival. The present study which was initiated by the Section of Neurooncology of the DGNC aimed to elucidate whether resection of recurrent GB is feasible at an acceptable complication rate and whether it has an effect on survival.
Methods: In a multicenter study patients initially resected for a primary GB between 01/06 and 06/10 and subsequently resected for a recurrent tumor were retrospectively assessed. Extent of resection of newly diagnosed and recurrent tumors was assessed as well as complications, time from initial to recurrent surgery, any radio- or chemotherapy and overall survival.
Results: Twenty neurosurgical departments participated and contributed 462 patients. So far, data of 339 patients underwent preliminary analysis. Median age at initial surgery was 57 years, median Karnofsky performance status (KPS) 90 prior to and after surgery. Resection was complete, > 90%, > 50% and < 50% in 53%, 38%, 9% and > 1%, respectively. Transient and permanent new deficits occurred in 5.6% and 3.5%. Median time from initial to recurrent resection was 8 months. Median KPS prior to recurrent resection was 90, postoperative KPS 80, transient and permanent new deficts occurred in 7.9% and 5.9%. Extent of resection of recurrent tumors was complete, > 90%, > 50% and < 50% in 58%, 25%, 16% and < 1%, respectively. 94 pts, 10 pts and 4 pts underwent resection for secondary, third and fourth recurrences. Median overall survival was 25 months and showed a significant dependance on extent of resection of the recurrent tumor.
Conclusions: The present study shows a long survival of this cohort of patients surgically treated for recurrent GB. Overall survival depends on extent of resection of the recurrent tumor. Though a major limitation of the study is the lack of a control group the data strongly support a survival benefit for patients resected for recurrent GB.
