Complete and Incomplete Resection for Progressive Glioblastoma Prolongs Post-Progression Survival

The role of resection in progressive glioblastoma (GBM) to prolong survival is still controversial. The aim of this study was to determine 1) the predictors of post-progression survival (PPS) in progressive GBM and 2) which subgroups of patients would benefit from recurrent resection. We have conduc...

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Published in:Frontiers in oncology 2022-02, Vol.12, p.755430-755430
Main Authors: Behling, Felix, Rang, Julia, Dangel, Elena, Noell, Susan, Renovanz, Mirjam, Mäurer, Irina, Schittenhelm, Jens, Bender, Benjamin, Paulsen, Frank, Brendel, Bettina, Martus, Peter, Gempt, Jens, Barz, Melanie, Meyer, Bernhard, Tatagiba, Marcos, Skardelly, Marco
Format: Article
Language:English
Subjects:
extent of resection
Oncology
post progression survival
progressive glioblastoma
re-surgery
recurrent surgery
surgery
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Summary:The role of resection in progressive glioblastoma (GBM) to prolong survival is still controversial. The aim of this study was to determine 1) the predictors of post-progression survival (PPS) in progressive GBM and 2) which subgroups of patients would benefit from recurrent resection. We have conducted a retrospective bicentric cohort study on isocitrate dehydrogenase ( ) wild-type GBM treated in our hospitals between 2006 and 2015. Kaplan-Maier analyses and univariable and multivariable Cox regressions were performed to identify predictors and their influence on PPS. Of 589 patients with progressive wild-type GBM, 355 patients were included in analyses. Median PPS of all patients was 9 months (95% CI 8.0-10.0), with complete resection 12 months (95% CI 9.7-14.3, n=81), incomplete resection 11 months (95% CI 8.9-13.1, n=70) and without resection 7 months (95% CI 06-08, n=204). Multivariable Cox regression demonstrated a benefit for PPS with complete (HR 0.67, CI 0.49-0.90) and incomplete resection (HR 0.73, 95% CI 0.51-1.04) and confirmed methylation of the gene promoter, lower age at diagnosis, absence of deep brain and multilocular localization, higher Karnofsky Performance Status (KPS) and recurrent therapies to be associated with longer PPS. In contrast, traditional eloquence and duration of progression-free survival had no effect on PPS. Subgroup analyses showed that all subgroups of confirmed predictors benefited from resection, except for patients in poor condition with a KPS
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2022.755430