BACKGROUND: Although reoperation likely confers survival benefit for glioblastoma, whether the extent of resection (EOR) of the reoperation affects survival outcome has yet to be thoroughly evaluated in the current temozolomide (TMZ) era. The aim of this meta-analysis was to pool the current literature and evaluate the prognostic significance of reoperation EOR for glioblastoma recurrence in the current TMZ era. METHODS: Searches of 7 electronic databases from inception to January 2019 were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. There were 1203 articles identified for screening. Prognostic hazard ratios (HRs) for overall survival (OS) derived from multivariate regression analysis were analyzed using meta-analysis of proportions. RESULTS: Nine individual studies satisfied all selection criteria, describing survival in 1507 patients with glioblastoma, including 1335 reoperations for recurrence (89%). When studies incorporated the EOR of index surgery into their analysis, maximal resection at reoperation was significantly prognostic for longer OS (HR, 0.59; 95% confidence interval [CI], 0.43-0.79; I2 = 0%; P heterogeneity <0.01). When studies did not incorporate the EOR of index surgery into their analysis, maximal resection remained significantly prognostic for longer OS at reoperation (HR, 0.53; 95% CI, 0.45-0.64; I2 = 5.2%; P heterogeneity <0.01). Based on EOR, radiographic gross total resection (GTR) was the most prognostic EOR definition at reoperation (HR, 0.52; 95% CI, 0.44-0.61; I2 = 0%; P heterogeneity <0.01). CONCLUSIONS: In the current TMZ era, when reoperation is feasible for recurrent glioblastoma, maximal safe resection appears to confer a significant OS benefit based on the current literature. This benefit is most pronounced with radiographic GTR, and likely irrespective of EOR at index surgery.
BACKGROUND: Although reoperation likely confers survival benefit for glioblastoma, whether the extent of resection (EOR) of the reoperation affects survival outcome has yet to be thoroughly evaluated in the current temozolomide (TMZ) era. The aim of this meta-analysis was to pool the current literature and evaluate the prognostic significance of reoperation EOR for glioblastoma recurrence in the current TMZ era. METHODS: Searches of 7 electronic databases from inception to January 2019 were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. There were 1203 articles identified for screening. Prognostic hazard ratios (HRs) for overall survival (OS) derived from multivariate regression analysis were analyzed using meta-analysis of proportions. RESULTS: Nine individual studies satisfied all selection criteria, describing survival in 1507 patients with glioblastoma, including 1335 reoperations for recurrence (89%). When studies incorporated the EOR of index surgery into their analysis, maximal resection at reoperation was significantly prognostic for longer OS (HR, 0.59; 95% confidence interval [CI], 0.43-0.79; I2 = 0%; P heterogeneity <0.01). When studies did not incorporate the EOR of index surgery into their analysis, maximal resection remained significantly prognostic for longer OS at reoperation (HR, 0.53; 95% CI, 0.45-0.64; I2 = 5.2%; P heterogeneity <0.01). Based on EOR, radiographic gross total resection (GTR) was the most prognostic EOR definition at reoperation (HR, 0.52; 95% CI, 0.44-0.61; I2 = 0%; P heterogeneity <0.01). CONCLUSIONS: In the current TMZ era, when reoperation is feasible for recurrent glioblastoma, maximal safe resection appears to confer a significant OS benefit based on the current literature. This benefit is most pronounced with radiographic GTR, and likely irrespective of EOR at index surgery.
Authors: Helle Sorensen von Essen; Frantz Rom Poulsen; Rikke Hedegaard Dahlrot; Karin Piil; Karina Dahl Steffensen Journal: Int J Environ Res Public Health Date: 2022-06-16 Impact factor: 4.614
Authors: Maria Lukina; Konstantin Yashin; Elena E Kiseleva; Anna Alekseeva; Varvara Dudenkova; Elena V Zagaynova; Evgenia Bederina; Igor Medyanic; Wolfgang Becker; Deependra Mishra; Mikhail Berezin; Vladislav I Shcheslavskiy; Marina Shirmanova Journal: Front Oncol Date: 2021-05-24 Impact factor: 6.244
Authors: Myungjun Ko; Monish R Makena; Paula Schiapparelli; Paola Suarez-Meade; Allatah X Mekile; Bachchu Lal; Hernando Lopez-Bertoni; Kristen L Kozielski; Jordan J Green; John Laterra; Alfredo Quiñones-Hinojosa; Rajini Rao Journal: PNAS Nexus Date: 2022-03-09
Authors: Maximilian A Kirchner; Adrien Holzgreve; Matthias Brendel; Michael Orth; Viktoria C Ruf; Katja Steiger; Dennis Pötter; Lukas Gold; Marcus Unterrainer; Lena M Mittlmeier; Enio Barci; Roland E Kälin; Rainer Glass; Simon Lindner; Lena Kaiser; Jessica Maas; Louisa von Baumgarten; Harun Ilhan; Claus Belka; Johannes Notni; Peter Bartenstein; Kirsten Lauber; Nathalie L Albert Journal: Front Oncol Date: 2021-11-17 Impact factor: 6.244
Authors: Montserrat Lara-Velazquez; Natanael Zarco; Anna Carrano; Jordan Phillipps; Emily S Norton; Paula Schiapparelli; Rawan Al-Kharboosh; Jordina Rincon-Torroella; Stephanie Jeanneret; Teresa Corona; Jose Segovia; Mark E Jentoft; Kaisorn L Chaichana; Yan W Asmann; Alfredo Quiñones-Hinojosa; Hugo Guerrero-Cazares Journal: Neuro Oncol Date: 2021-04-12 Impact factor: 12.300