Surgical Management of Glioblastoma Multiforme
DOI:
https://doi.org/10.47672/ajhmn.1052Keywords:
Glioblastoma, Tumours, Progressive GB, MalignantAbstract
Background: Although glioblastoma (GB) is kept up to date, rate of progress is nearly unavoidable. Earlier researches put forward the endurance advantages with removal of GB; but comparatively a small number of literatures have assessed the role of operative intervention in glioblastoma management.
Objective: The aim of this research is to assess the results of surgical resections in patients with glioblastoma.
Methods: Study conducted in Bacha Khan Medical College, Mardan Medical Complex Records were retrospectively identified and reviewed for all individuals that went through gliolastoma biopsy or its removal between Oct 2017 and Dec 2020 to identify 50 progressive GB patients. The Kaplan-Meier method produced median survival and 95 percent CI. The Cox Proportional Risks model was used for the multivarian analysis, which conducted for age, Karnofsky score, extent of resection, and tumor site and tumor multifocality of survival after the advancement of disease.
Results: Patients with progressing illness received first recorded resection. The median survival after progression was 12.8 and 7.0 months for patients who had not received resections at this time. In multivariable analyses, KPS 0.70 (HR 0.438), and surgical intervention were linked with better survival after advancement of glioblastoma.
Recommendations: In the circumstance of present maximum non-operative treatment, operative intervention for advancing glioblastoma is effective in controlling the symptoms but however, the survival of the patients is limited. Further research is required to determine if any, the role of surgical intervention may prolong post-progressive endurance in progressive GB individuals.
Downloads
References
Ostrom QT, Gittleman H, Fulop J, et al. CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2008-2012. Neuro Oncol. Oct 2015;17 Suppl 4:iv1-iv62.
Nabors LB, Portnow J, Ammirati M, et al. Central Nervous System Cancers, Version 1.2015. J. Natl. Compr. Canc. Netw. Oct 2015;13(10):1191-1202.
Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N. Engl. J. Med. Mar 10 2005;352(10):987-996.
Stummer W, Reulen HJ, Meinel T, et al. Extent of resection and survival in glioblastoma multiforme: identification of and adjustment for bias. Neurosurgery. Mar 2008;62(3):564-576; discussion 564-576.
Gilbert MR, Dignam JJ, Armstrong TS, et al. A randomized trial of bevacizumab for newly diagnosed glioblastoma. N. Engl. J. Med. Feb 20 2014;370(8):699-708.
Weller M, van den Bent M, Hopkins K, et al. EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. Lancet Oncol. Aug 2014;15(9):e395-403.
Montemurro N, Perrini P, Blanco MO, Vannozzi R. Second surgery for recurrent glioblastoma: A concise overview of the current literature. Clin. Neurol. Neurosurg. Mar 2016;142:60-64.
Suchorska B, Weller M, Tabatabai G, et al. Complete resection of contrast-enhancing tumor volume is associated with improved survival in recurrent glioblastoma-results from the DIRECTOR trial. Neuro Oncol. Apr 2016;18(4):549-556.
Chaichana KL, Zadnik P, Weingart JD, et al. Multiple resections for patients with glioblastoma: prolonging survival. J. Neurosurg. Apr 2013;118(4):812-820.
Stark AM, Nabavi A, Mehdorn HM, Blomer U. Glioblastoma multiforme-report of 267 cases treated at a single institution. Surg. Neurol. Feb 2005;63(2):162-169; discussion 169.
Ringel F, Pape H, Sabel M, et al. Clinical benefit from resection of recurrent glioblastomas: results of a multicenter study including 503 patients with recurrent glioblastomas undergoing surgical resection. Neuro Oncol. Jan 2016;18(1):96-104.
Oppenlander ME, Wolf AB, Snyder LA, et al. An extent of resection threshold for recurrent glioblastoma and its risk for neurological morbidity. J. Neurosurg. Apr 2014;120(4):846-853.
Brandes AA, Bartolotti M, Tosoni A, et al. Patient outcomes following second surgery for recurrent glioblastoma. Future Oncol. Apr 2016;12(8):1039-1044.
Yong RL, Wu T, Mihatov N, et al. Residual tumor volume and patient survival following reoperation for recurrent glioblastoma. J. Neurosurg. Oct 2014;121(4):802-809.
Quick J, Gessler F, Dutzmann S, et al. Benefit of tumor resection for recurrent glioblastoma. J. Neurooncol. Apr 2014;117(2):365-372.
Bloch O, Han SJ, Cha S, et al. Impact of extent of resection for recurrent glioblastoma on overall survival: clinical article. J. Neurosurg. Dec 2012;117(6):1032-1038.
Johnson DR, Leeper HE, Uhm JH. Glioblastoma survival in the United States improved after Food and Drug Administration approval of bevacizumab: a population-based analysis. Cancer. Oct 1 2013;119(19):3489-3495.
Ortega A, Sarmiento JM, Ly D, et al. Multiple resections and survival of recurrent glioblastoma patients in the temozolomide era. J. Clin. Neurosci. Feb 2016;24:105-111.
Clarke JL, Ennis MM, Yung WK, et al. Is surgery at progression a prognostic marker for improved 6-month progression-free survival or overall survival for patients with recurrent glioblastoma? Neuro Oncol. Oct 2011;13(10):1118-1124
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Naeem Ul Haq, Muhammad Idris Khan, Abdul Jalal, Inyat Shah, Musawer Khan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
