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. 2000;2000(2):CD002034.
doi: 10.1002/14651858.CD002034.

Biopsy versus resection for malignant glioma

S E Metcalfe  1
Affiliations

Biopsy versus resection for malignant glioma

S E Metcalfe. Cochrane Database Syst Rev. 2000.

Update in

Abstract

Background: Patients with isolated supratentorial brain tumours, presumed to be primary on imaging, have two surgical management options - biopsy or resection. Surgical opinions appear to be equally divided when considering the relative risks and benefits of these two procedures.

Objectives: To estimate the clinical effectiveness of radical surgical resection compared to simple biopsy in patients with malignant glioma.

Search strategy: Electronic database searches of COCHRANE CONTROLLED TRIALS REGISTER (including the Cochrane Cancer Network Specialised Register of Trials), MEDLINE, CANCERLIT, EMBASE, BIOSIS and SCIENCE CITATION INDEX. Hand searching the references of all identified studies; hand searching the Journal of Neuro-Oncology over the previous 10 years, including all conference abstracts; personal communication.

Selection criteria: Randomised and clinical controlled trials were included if they compared biopsy to resection, or looked at effect of extent of resection on survival, time to progression or quality of life, for malignant glioma patients of all ages.

Data collection and analysis: Studies were to be identified, critically appraised and data extracted by the author (SEM). For dichotomous data, Peto odds ratios (OR) with 95% confidence intervals (CI) were hoped to have been estimated. Normal continuous data were to have been summated using the weighted mean difference (WMD).

Main results: The electronic database search yielded 2100 citations. Of these, two articles were identified for possible inclusion, however both were excluded. The hand search and personal communication were similarly unproductive. No studies were included in the review and no data was synthesised.

Reviewer's conclusions: Given that no qualifying studies were identified and because this is an important issue, both in terms of patient risk and benefit and health economics, the author feels it important to conduct a randomised controlled trial in this subject.

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Conflict of interest statement

None known

Figures

Analysis 1.1
Analysis 1.1
Comparison 1 Survival, Outcome 1 Survival.
See this image and copyright information in PMC

References

References to studies included in this review

    1. Vuorinen V, Hinkka S, Farkkila M, Jaaskelainen J. Debulking or biopsy of malignant glioma in elderly people ‐ a randomised study. Acta Neurochirurgica 2003;145:5‐10. - PubMed

References to studies excluded from this review

    1. Brem H, Piantadosi S, Burger PC, Walker M, Selker R, Vick NA, et al. Placebo controlled trial of safety and efficacy of intra‐operative controlled delivery by biodegradable polymers of chemotherapy for recurrent glioma. Lancet 1995;345:1008‐12. - PubMed
    1. Eljamel MS, Goodman C, Moseley H. ALA and Photofrin(®) Fluorescence‐guided resection and repetitive PDT in glioblastoma multiforme: a single centre Phase III randomised controlled trial. Lasers in Medical Science 2008;23:361‐67. - PubMed
    1. Fadul C, Wood J, Thaler H, Galicich J, Patterson RH Jr, Posner JB. Morbidity and mortality of craniotomy for excision of supra‐tentorial gliomas. Neurology 1988;38(9):1374‐9. - PubMed
    1. Gupta DK, Chandra PS, Ojha BK, et al. Awake craniotomy versus surgery under general anaesthesia for resection of intrinsic lesions in eloquent cortex ‐ A prospective randomised study. Clinical Neurology and Neurosurgery 2007;109:335‐43. - PubMed
    1. Proescholdt MA, Macher C, Woertgen C, Brawanski A. Level of evidence in the literature concerning brain tumour resection. Clinical Neurology and Neurosurgery 2005;107:95‐8. - PubMed

Additional references

    1. Counsell CE, Grant R. Incidence studies of primary and secondary intracranial tumors: a systematic review of their methodology and results. Journal of Neuro‐Oncology 1998;37(3):241‐50. - PubMed
    1. Centre for Reviews and Dissemintation. Systematic Reviews: CRD's guidance for undertaking reviews in health care. York: York Publishing Services Limited, 2009.
    1. Curran WJ Jr, Scott CB, Horton J, Nelson JS, Weinstein AS, Fischbach AJ, et al. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group Malignant Glioma Trials. Journal of the National Cancer Institute 1993;85:704‐10. - PubMed
    1. DerSimonian R, Laird N. Meta‐analysis in clinical trials. Controlled Clinical Trials 1986;7:177‐88. - PubMed
    1. Devaux BC, O'Fallon JR, Kelly PJ. Resection, biopsy and survival in malignant glial neoplasms. Journal of Neurosurgery 1993;78:767‐75. - PubMed

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