Supramaximal versus gross total resection in Glioblastoma, IDH wild-type and Astrocytoma, IDH-mutant, grade 4, effect on overall and progression free survival: systematic review and meta-analysis

Purpose To synthesize the evidence on the impact on progression-free survival (PFS) and overall survival (OS) of supramaximal resection (SMR) over gross total resection (GTR) in Glioblastoma, IDH wild-type and Astrocytoma, IDH-mutant, grade 4 (Glioblastoma). Methods The PubMed, Scopus, Web of Scienc...

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Published in:Journal of neuro-oncology 2023-08, Vol.164 (1), p.31-41
Main Authors: Mier-García, Juan F., Ospina-Santa, Stefanía, Orozco-Mera, Javier, Ma, Ruichong, Plaha, Puneet
Format: Article
Language:English
Subjects:
Astrocytoma
Brain cancer
Glioblastoma
Magnetic resonance imaging
Medical prognosis
Medicine
Medicine & Public Health
Meta-analysis
Mutants
Nervous system
Neurology
Neurosurgery
Oncology
Patients
Review
Survival
Systematic review
Tumors
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Summary:Purpose To synthesize the evidence on the impact on progression-free survival (PFS) and overall survival (OS) of supramaximal resection (SMR) over gross total resection (GTR) in Glioblastoma, IDH wild-type and Astrocytoma, IDH-mutant, grade 4 (Glioblastoma). Methods The PubMed, Scopus, Web of Science, Ovid and Cochrane databases were systematically searched (up to November 30, 2022). Studies reporting OS and PFS on adult humans with a suspected Glioblastoma, treated either with a SMR or GTR were included. Hazard ratios were estimated for each study and treatment effects were calculated through DerSimonian and Laird random effects models. Results The literature search yielded 14 studies published between 2013 and 2022, enrolling a total of 6779 patients. Analysis of the included studies reveals significantly better clinical outcomes favoring SMR over GTR in terms of PFS (HR 0.67; p = 0.0007), and OS (HR 0.7; p = 0.0001). Conclusion Glioblastoma, IDH wild-type and Astrocytoma, IDH-mutant, grade 4, are aggressive tumors with a very short long-term OS. SMR is an effective therapeutic approach contributing to increased PFS and OS in patients with this catastrophic disease.
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-023-04409-0