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

被引:183
作者
Ringel, Florian [1 ]
Pape, Haiko [1 ]
Sabel, Michael [2 ]
Krex, Dietmar [3 ]
Bock, Hans Christoph [4 ]
Misch, Martin [5 ]
Weyerbrock, Astrid [6 ]
Westermaier, Thomas [7 ]
Senft, Christian [8 ]
Schucht, Philippe [9 ]
Meyer, Bernhard [1 ]
Simon, Matthias [10 ]
机构
[1] Tech Univ Munich, Klinikum Rechts Isar, Dept Neurosurg, Ismaninger Str 22, D-81675 Munich, Germany
[2] Univ Dusseldorf, Dept Neurosurg, Dusseldorf, Germany
[3] Univ Klinikum Carl Gustav Carus, Dept Neurosurg, Dresden, Germany
[4] Univ Med Gottingen, Dept Neurosurg, Gottingen, Germany
[5] Charite, Dept Neurosurg, D-13353 Berlin, Germany
[6] Univ Freiburg Klinikum, Dept Neurosurg, Freiburg, Germany
[7] Univ Klinikum Wurzburg, Dept Neurosurg, Wurzburg, Germany
[8] Goethe Univ Frankfurt, Dept Neurosurg, D-60054 Frankfurt, Germany
[9] Univ Klinikum Bern, Dept Neurosurg, Inselspital, Bern, Switzerland
[10] Univ Bonn, Univ Kliniken Bonn, Dept Neurosurg, Bonn, Germany
关键词
glioblastoma; overall survival; recurrent tumor; surgical resection; PHASE-II TRIAL; SINGLE-AGENT BEVACIZUMAB; MALIGNANT GLIOMA; STEREOTACTIC REIRRADIATION; PROGNOSTIC-FACTORS; REPEATED SURGERY; ADULT PATIENTS; TEMOZOLOMIDE; SURVIVAL; REOPERATION;
D O I
10.1093/neuonc/nov145
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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. 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. 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%. The present study supports the view that surgical resections of recurrent glioblastomas may help to prolong patient survival at an acceptable complication rate.
引用
收藏
页码:96 / 104
页数:9
相关论文
共 50 条
[11]   Generation and validation of a prognostic score to predict outcome after re-irradiation of recurrent glioma [J].
Combs, Stephanie E. ;
Edler, Lutz ;
Rausch, Renate ;
Welzel, Thomas ;
Wick, Wolfgang ;
Debus, Juergen .
ACTA ONCOLOGICA, 2013, 52 (01) :147-152
[12]   Phase II Study of Aflibercept in Recurrent Malignant Glioma: A North American Brain Tumor Consortium Study [J].
de Groot, John F. ;
Lamborn, Kathleen R. ;
Chang, Susan M. ;
Gilbert, Mark R. ;
Cloughesy, Timothy F. ;
Aldape, Kenneth ;
Yao, Jun ;
Jackson, Edward F. ;
Lieberman, Frank ;
Robins, H. Ian ;
Mehta, Minesh P. ;
Lassman, Andrew B. ;
DeAngelis, Lisa M. ;
Yung, W. K. Alfred ;
Chen, Alice ;
Prados, Michael D. ;
Wen, Patrick Y. .
JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (19) :2689-2695
[13]   A multi-institutional phase II study on second-line Fotemustine chemotherapy in recurrent glioblastoma [J].
Fabrini, Maria Grazia ;
Silvano, Giovanni ;
Lolli, Ivan ;
Perrone, Franco ;
Marsella, Annarita ;
Scotti, Valerio ;
Cionini, Luca .
JOURNAL OF NEURO-ONCOLOGY, 2009, 92 (01) :79-86
[14]   Bevacizumab Alone and in Combination With Irinotecan in Recurrent Glioblastoma [J].
Friedman, Henry S. ;
Prados, Michael D. ;
Wen, Patrick Y. ;
Mikkelsen, Tom ;
Schiff, David ;
Abrey, Lauren E. ;
Yung, W. K. Alfred ;
Paleologos, Nina ;
Nicholas, Martin K. ;
Jensen, Randy ;
Vredenburgh, James ;
Huang, Jane ;
Zheng, Maoxia ;
Cloughesy, Timothy .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (28) :4733-4740
[15]  
Grossman SA, 2007, J CLIN ONCOL, V25, DOI 10.1200/JCO.2006.08.1661
[16]   Two phase II trials of temozolomide with interferon-α2b (pegylated and non-pegylated) in patients with recurrent glioblastoma multiforme [J].
Groves, M. D. ;
Puduvalli, V. K. ;
Gilbert, M. R. ;
Levin, V. A. ;
Conrad, C. A. ;
Liu, V. H. ;
Hunter, K. ;
Meyers, C. ;
Hess, K. R. ;
Yung, W. K. Alfred .
BRITISH JOURNAL OF CANCER, 2009, 101 (04) :615-620
[17]   REOPERATION FOR RECURRENT GLIOBLASTOMA AND ANAPLASTIC ASTROCYTOMA [J].
HARSH, GR ;
LEVIN, VA ;
GUTIN, PH ;
SEAGER, M ;
SILVER, P ;
WILSON, CB .
NEUROSURGERY, 1987, 21 (05) :615-621
[18]   Cetuximab, bevacizumab, and irinotecan for patients with primary glioblastoma and progression after radiation therapy and temozolomide: a phase II trial [J].
Hasselbalch, Benedikte ;
Lassen, Ulrik ;
Hansen, Steinbjorn ;
Holmberg, Mats ;
Sorensen, Morten ;
Kosteljanetz, Michael ;
Broholm, Helle ;
Stockhausen, Marie-Therese ;
Poulsen, Hans Skovgaard .
NEURO-ONCOLOGY, 2010, 12 (05) :508-516
[19]   Overall survival, prognostic factors, and repeated surgery in a consecutive series of 516 patients with glioblastoma multiforme [J].
Helseth, R. ;
Helseth, E. ;
Johannesen, T. B. ;
Langberg, C. W. ;
Lote, K. ;
Ronning, P. ;
Scheie, D. ;
Vik, A. ;
Meling, T. R. .
ACTA NEUROLOGICA SCANDINAVICA, 2010, 122 (03) :159-167
[20]   Surgical outcomes in recurrent glioma Clinical article [J].
Hoover, Jason M. ;
Nwojo, Macaulay ;
Puffer, Ross ;
Mandrekar, Jay ;
Meyer, Fredric B. ;
Parney, Ian F. .
JOURNAL OF NEUROSURGERY, 2013, 118 (06) :1224-1231