gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Is there a need for re-operation for recurrent glioblastoma?

Meeting Abstract

  • D. Krex - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland
  • C. Lindner - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland
  • T. Juratli - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland
  • C. Raue - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland
  • G. Schackert - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocDI.03.08

DOI: 10.3205/11dgnc121, URN: urn:nbn:de:0183-11dgnc1219

Published: April 28, 2011

© 2011 Krex 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

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Objective: The primary treatment of glioblastoma (GBM) has been standardized in recent years. However, the treatment of recurrent glioblastoma is less well defined. It is a matter of debate, if, when, how extensive and in which way a recurrent tumor should be neurosurgically treated. Therefore, we retrospectively analyzed a well-characterized glioblastoma population including one-third of patients who had repeated surgery for recurrent tumors.

Methods: We performed a retrospective analysis of patients who had been treated for primary and recurrent GBM between 2004 and 2010 at our Department. Clinical parameters, progression-free and overall survival were determined and evaluated by using chi-square and Kaplan-Maier statistics.

Results: The entire population comprised 381 patients. 119 patients had a second, 35 a third, and 4 patients a fourth operation. 249 patients had no second operation, while 13 patients, who had no evidence for tumor after recurrent surgery according to histopathological diagnosis, were disregarded. The median age was 64.5, 60, and 68 years for the entire population, with and without second operation, respectively. Karnofsky Performance Score at admission was >70 in all cases. Radiotherapy was applied to 90%, 95%, and 87% and any kind of chemotherapy to 64%, 70%, and 59% of the entire population, those with second and without second operation, respectively. Median overall survival was 13.5 months for the entire population, 18.5 months for those who had second operation, and 9.7 months for those without second operation (p<0.001).

Conclusions: In our series, patients who had been operated for recurrent glioblastoma had almost twice as long median overall survival than those who had not. Our data confirm that close follow-up and aggressive treatment including repeated surgery is effective in prolonging overall survival for glioblastoma patients.