Second surgery for recurrent glioblastoma: advantages and pitfalls.

Deciding upon the therapeutic approach for patients with recurrent glioblastoma is a challenge. Although second surgery may provide effective palliation, it has yet to be established whether it prolongs survival and/or improves quality of life; nor have data been reported in literature to demonstrate that repeat surgery is indicated for patients with recurrence. The few studies investigating this issue are retrospective and have been conducted on small series, and their data sets are not homogeneous. The aim of the present study was, therefore, to analyze predictors of outcome in patients with recurrent glioblastoma and to make a critical of review of data in literature with a view to comparing the effect on outcome of second surgery against well-known prognostic determinants.