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. 2022 Jul 13;4(1):vdac115.
doi: 10.1093/noajnl/vdac115. eCollection 2022 Jan-Dec.

Reoperation in adult patients with recurrent glioblastoma: A matched cohort analysis

Kaiyun Yang  1 , Yosef Ellenbogen  1 , Amanda Martyniuk  1 , Michel Sourour  1 , Radwan Takroni  1 , Mohamed Somji  1 , Emily Gardiner  2 , Katrina Hui  3 , Devang Odedra  4 , Ramiro Larrazabal  4 , Almunder Algird  1 , Edward Kachur  1 , Kesava Reddy  1 , Naresh Murty  1 , Forough Farrokhyar  5 , Sheila K Singh  1
Affiliations

Reoperation in adult patients with recurrent glioblastoma: A matched cohort analysis

Kaiyun Yang et al. Neurooncol Adv. .

Abstract

Background: Despite maximal safe cytoreductive surgery and postoperative adjuvant therapies, glioblastoma (GBM) inevitably recurs and leads to deterioration of neurological status and eventual death. There is no consensus regarding the benefit of repeat resection for enhancing survival or quality of life in patients with recurrent GBM. We aimed to examine if reoperation for GBM recurrence incurs a survival benefit as well as examine its complication profile.

Methods: We performed a single-center retrospective chart review on all adult patients who underwent resection of supratentorial GBM between January 1, 2008 and December 1, 2013 at our center. Patients with repeat resection were manually matched for age, sex, tumor location, and Karnofsky Performance Status (KPS) with patients who underwent single resection to compare overall survival (OS), and postoperative morbidity.

Results: Of 237 patients operated with GBM, 204 underwent single resection and 33 were selected for repeat surgical resections. In a matched analysis there was no difference in the OS between groups (17.8 ± 17.6 months vs 17 ± 13.5 months, P = .221). In addition, repeat surgical resection had a higher rate of postoperative neurological complications compared to the initial surgery.

Conclusions: When compared with matched patients who underwent a single surgical resection, patients undergoing repeat surgical resection did not show significant increase in OS and may have incurred more neurological complications related to the repeat resection. Further studies are required to assess which patients would benefit from repeat surgical resection and optimize timing of the repeat resection in selected patients.

Keywords: glioblastoma; overall survival; recurrence; reoperation.

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Figures

Figure 1.
Figure 1.
Kaplan–Meier survival curves revealed no significant difference in median survival in matched patient cohorts. The median survival time was 13.3 months (95% CI 11.3–15.3) in the single resection cohort and 16.7 months (95% CI 15.3–18.2) in the repeat resection group (P = .301).
See this image and copyright information in PMC

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