gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

The influence of extent of resection on overall survival in primary glioblastoma – follow-up results of a randomized trial

Meeting Abstract

  • Christian Senft - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt
  • Florian Geßler - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt
  • Andrea Bink - Institut für Neuroradiologie, Universitätsklinikum Frankfurt
  • Kea Franz - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt
  • Volker Seifert - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 184

doi: 10.3205/14dgnc578, urn:nbn:de:0183-14dgnc5780

Published: May 13, 2014

© 2014 Senft et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: In a randomized trial the use of an intraoperative MRI led to improved rates of complete tumor removal. In this study, complete tumor removal was associated with longer progression-free survival. However, overall survival (OS) was not addressed in the primary analysis.

Method: We performed a secondary analysis of survival data of patients with primary glioblastomas who participated in a clinical trial comparing conventional with intraoperative MRI guided microsurgery that was published before. All patients underwent tumor removal between Oct 2007 and Jul 2010. Adjuvant therapy was administered according to interdisciplinary board decision and patient preference.

Results: We analyzed survival data of 37 patients with a median age of 56 years (range: 30–76). Median OS was 20.1 months. While the use of iMRI itself did not affect outcome (p=0.40), patients with a radiologically complete resection had longer OS than patients with residual contrast enhancing tumor (26.0 vs. 13.4 months, p<0.05). There was a trend for clinical status influencing OS: patients with KPS≥90 had an OS of 24.1 months, while it was only 13.4 for patients with KPS≤80 (p=0.09). Patient age was not a statistically significant factor concerning OS (p=0.48). On multivariate analysis, completeness of resection, in contrast to KPS, remained statistically significant (p<0.05).

Conclusions: Radiologically complete removal of contrast enhancing tissue is an important prognostic factor for patients with primary GBM. Use of intraoperative MRI helps to achieve a higher rate of complete resections and thus directly impacts patient outcome.