Clinical benefit from resection of recurrent glioblastomas: results of a multicenter study including 503 patients with recurrent glioblastomas undergoing surgical resection

Florian Ringel, Haiko Pape, Michael Sabel, Dietmar Krex, Hans Christoph Bock, Martin Misch, Astrid Weyerbrock, Thomas Westermaier, Christian Senft, Philippe Schucht, Bernhard Meyer, Matthias Simon, SN1 study group, Haiko Pape, Bernhard Meyer, Florian Ringel, Matthias Simon, Michael Sabel, Marion Rapp, Dietmar Krex, Hans Christoph Bock, Veit Rohde, Astrid Weyerbrock, Marcia R Machein, Thomas Westermaier, Ralf-Ingo Ernestus, Kea Franz, Christian Senft, Philippe Schucht, Jürgen Beck, Martin Misch, Peter Vajkoczy, Mehrdad Salehi, Mario Carvi Nievas, Hans-Georg Höllerhage, Thomas Schneider, Humberto Tapia-Perez, Anke Höllig, Hans Clusmann, Wiebke Aumann, Thomas Kretschmer, Marcel Seiz-Rosenhagen, Claudius Thomé, Rüdiger Buchalla, Christian Groß, Florian Stockhammer, Ivan Radovanovic, Karl Schaller, Petra Wolf, Florian Ringel, Haiko Pape, Michael Sabel, Dietmar Krex, Hans Christoph Bock, Martin Misch, Astrid Weyerbrock, Thomas Westermaier, Christian Senft, Philippe Schucht, Bernhard Meyer, Matthias Simon, SN1 study group, Haiko Pape, Bernhard Meyer, Florian Ringel, Matthias Simon, Michael Sabel, Marion Rapp, Dietmar Krex, Hans Christoph Bock, Veit Rohde, Astrid Weyerbrock, Marcia R Machein, Thomas Westermaier, Ralf-Ingo Ernestus, Kea Franz, Christian Senft, Philippe Schucht, Jürgen Beck, Martin Misch, Peter Vajkoczy, Mehrdad Salehi, Mario Carvi Nievas, Hans-Georg Höllerhage, Thomas Schneider, Humberto Tapia-Perez, Anke Höllig, Hans Clusmann, Wiebke Aumann, Thomas Kretschmer, Marcel Seiz-Rosenhagen, Claudius Thomé, Rüdiger Buchalla, Christian Groß, Florian Stockhammer, Ivan Radovanovic, Karl Schaller, Petra Wolf

Abstract

Background: While standards for the treatment of newly diagnosed glioblastomas exist, therapeutic regimens for tumor recurrence remain mostly individualized. The role of a surgical resection of recurrent glioblastomas remains largely unclear at present. This study aimed to assess the effect of repeated resection of recurrent glioblastomas on patient survival.

Methods: In a multicenter retrospective-design study, patients with primary glioblastomas undergoing repeat resections for recurrent tumors were evaluated for factors affecting survival. Age, Karnofsky performance status (KPS), extent of resection (EOR), tumor location, and complications were assessed.

Results: Five hundred and three patients (initially diagnosed between 2006 and 2010) undergoing resections for recurrent glioblastoma at 20 institutions were included in the study. The patients' median overall survival after initial diagnosis was 25.0 months and 11.9 months after first re-resection. The following parameters were found to influence survival significantly after first re-resection: preoperative and postoperative KPS, EOR of first re-resection, and chemotherapy after first re-resection. The rate of permanent new deficits after first re-resection was 8%.

Conclusion: The present study supports the view that surgical resections of recurrent glioblastomas may help to prolong patient survival at an acceptable complication rate.

Keywords: glioblastoma; overall survival; recurrent tumor; surgical resection.

© The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Figures

Fig. 1.
Fig. 1.
Influence of extent of resection at initial surgery and first re-resection on survival.
Fig. 2.
Fig. 2.
Kaplan Meier survival analysis after first re-resection depending on adjuvant therapy after first re-resection.
Fig. 3.
Fig. 3.
Conservative (left) and explorative (right) classification and regression tree model of factors influencing survival after first re-resection. Median overall survivals are given in the respective Kaplan Maier plots.

Source: PubMed

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