gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Impact of fluorescence guided resection and Stupp protocol on overall survival in glioblastoma patients – results from a continuous single centre database

Meeting Abstract

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  • P. Slotty - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • B. Siantidis - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • H.J. Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • M. Sabel - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.09.01

doi: 10.3205/12dgnc079, urn:nbn:de:0183-12dgnc0794

Published: June 4, 2012

© 2012 Slotty 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: Fluorescence guided surgery (FGS) and concomitant radiochemotherapy according to the Stupp protocol have impressively improved outcome in glioblastoma (GBM) patients over the past years. Multicentre trials have demonstrated the efficacy of these options. We investigated the impact of these treatment strategies on the overall survival (OAS) using a single centre database.

Methods: 253 patients treated for newly diagnosed, primary GBM between 1990 and 2009 were reviewed for this survey. Patients were divided into three treatment groups: A(FGS-/Stupp-), B(FGS-/Stupp+) and C (FGS+/Stupp+). Kaplan-Meyer and Cox regression analysis were performed to determine coherence between treatment group, age, gender, Karnofsky performance score, MGMT methylation status and OAS.

Results: Epidemiological and medical data were completely available in 253 patients (A = 163, B = 22, C = 68) Median OAS in months differed significantly between the groups (A = 8.8 month, B = 13.6 month, C = 20.1 month, p < 0.01). Known epidemiological factors influencing outcome did not significantly differ between treatment groups. Degree of resection (p < 0.01, beta = 0.54, CI 0.34–0.85), MGMT-methylation status (p < 0.01, beta = 0.516, CI 0.336–0.793) and age at surgery (p = 0.05, beta = 1.022, CI 1.002–1.042) did significantly influence OAS. KPS prior to surgery and gender did not significantly influence OAS.

Conclusions: FGS and the Stupp protocol induce an impressive improvement in OAS in glioblastoma patients. This effect is not limited to multicentre trials but is reproducible in routine treatment in a neurosurgical centre.