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

Benefit of resection in recurrent glioblastoma

Meeting Abstract

  • J. Quick - Klinik und Poliklinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • S. Dützmann - Klinik und Poliklinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • E. Hattingen - Institut für Neuroradiologie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • K. Franz - Klinik und Poliklinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • V. Seifert - Klinik und Poliklinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • C. Senft - Klinik und Poliklinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main

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.09.11

DOI: 10.3205/12dgnc089, URN: urn:nbn:de:0183-12dgnc0894

Published: June 4, 2012

© 2012 Quick et al.
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Outline

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Objective: The positive impact of neurosurgical resection in first line therapy of glioblastoma (GBM) is beyond controversy. The possible positive impact of re-resection in case of tumor recurrence remains unclear.

Methods: We performed a retrospective analysis of our prospectively collected data base and evaluated all re-resected patients with primary GBM, who underwent second surgery in a period of 3 years (Oct 2007–Sep 2010). All patients were examined by early postoperative MRI. We determined survival after re-resection with regard to possible prognostic factors (age, KPS, tumor volume, MSM-score and extent of resection) using Kaplan Meier estimates and Cox-regression analysis.

Results: 41 Patients underwent re-resection. Median age was 58 years (30–76 years), median KPS score was 80 (50–100). The average tumor volume was 5.05 cm3 (0.2–48.5 cm3). A radiologically complete resection was achieved in 30 patients (73.2%). The median follow-up time was 18.8 months. The median survival time after re-resection was 13.5 months, overall survival was 21.6 months. Prognostic factors for survival after re-resection were good clinical condition (KPS ≥ 80) and extent of resection (p < 0.01 for both).Time between first diagnosis and re-resection (p = 0.34), tumor volume at recurrence (p = 0.98), MSM score (p = 0.83) and patient age (p = 0.09) were no significant factors.

Conclusions: In the event of tumor recurrence, extent of resection is a significant prognostic factor for postoperative survival in patients with primary GBM and, along with KPS, plays a more important role than patient age. Thus, patients in good clinical condition with recurrent GBM amenable to complete resection should not be withheld surgery as a treatment option.