gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Impact of Pre- and Postoperative Tumor Volume in recurrent Glioblastoma

Meeting Abstract

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  • Julia Gerhardt - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, der Technischen Universität München, München, Deutschland
  • Stefanie Bette - Neurochirurgische Klinik und Poliklinik Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
  • Thomas Huber - Neurochirurgische Klinik und Poliklinik Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
  • Melanie Barz - Neurochirurgische Klinik und Poliklinik Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
  • Niels Buchmann - München, Deutschland
  • Yu-MI Ryang - München, Deutschland
  • Bernhard Meyer - München, Deutschland
  • Jens Gempt - München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.03.04

doi: 10.3205/17dgnc194, urn:nbn:de:0183-17dgnc1943

Published: June 9, 2017

© 2017 Gerhardt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Treatment standards for newly diagnosed glioblastomas are well established and extend of resection is a significant prognostic factor on overall survival. Complete tumor resection is also for recurrent glioblastoma an important prognostic factor. To date however only few studies adressed the role of pre- and postoperative tumor volume in recurrent glioblastomas. Aim of this study therefore was to assess the influence of preoperative and postoperative tumor volume in recurrent glioblastoma on overall survival.

Methods: Patients treated between January 2007 and April 2016 were retrospectively assessed. Inclusion criteria comprised surgery for 1st recurrence of glioblastoma and available received pre- and postoperative MRI. Age, sex, pre- and postoperative tumor volume, survival after recurrent surgery (post-progression survival (PPS)), pre- and postoperative Karnofsky-Performance-Status-Scale (KPS) and molecular status were recorded.

Results: 102 (39 female, 63 male) consecutive patients with a mean age of 58.4±11.3 years (range 21-79) received surgical therapy for first recurrent glioblastoma between May 2006 and June 2015 in our department. Median preoperative tumor volume was 11.9cm3 (IR 3.2-27.4cm3) and median postoperative tumor volume 0.2cm3 (IR 0-1.3cm3). Complete resection was achieved in 43/102 cases (42.2%) and is an important prognostic factor for PPS in univariate analysis (P<0.001; 11.0 months (95% CI 8.3-13.7) vs. 7.0 months (5.0-9.0)). Complete tumor resection (HR 2.176 [1.280-3.699], P=0.004) did also remain significant in multivariate analysis including age (<60/>=60years, HR 1.541 [0.943-2.519], P=0.084), postoperative KPS (<80/>=80, HR 1.642 [0.977-2.760], P=0.061) and preoperative tumor volume (cm³, HR 1.008 [0.999-1.017], P=0.067). Postoperative tumor volume (cm³, HR 1.051 [0.962-1.147], P=0.270) missed statistical significance in multivariate analysis.

Conclusion: Complete tumor resection at first recurrence is an important prognostic factor for PPS in glioblastoma patients. A trend towards improved survival with less residual tumor burden at first recurrence was observed. Preoperative tumor volume at first recurrence was not shown as significant prognostic factor.