BACKGROUND: A relationship between the extent of resection (EOR) and survival has been demonstrated in patients with glioblastomas (GBMs). However, despite gross total resection (GTR) of the enhancing nodule (EN), GBMs usually relapse, generally near the surgical cavity. OBJECTIVE: The aim of this study was to determine the prognostic role of FLAIR resection of GBMs by analyzing pre- and post-operative MRIs to estimate the EOR of EN, FLAIR-hyperintense regions and total tumor volume (TTV). METHODS: Radiologic and clinical outcomes were analyzed retrospectively. Pre- and post-operative EN volume, pre- and postoperative FLAIR volume (POFV), and pre- and postoperative TTV were analyzed. EOR was then calculated for each component. Time-dependent ROC curves and cut-off values for pre- and post-operative volumes and EOR were calculated. A Kaplan-Meier analysis with the log-rank test and Cox regression analysis were then used to analyze progression-free survival (PFS) and overall survival (OS). RESULTS: We did not find any correlation between EOR of FLAIR-altered regions and patient survival. On the other hand, there were statistically significant relationships between the prognosis and both a preoperative EN volume less than 31.35 cm3 (p=0.032) and a postoperative EN volume less than 0.57 cm3 (p=0.015). Moreover, an EOR of EN greater than 96% was significantly associated with the prognosis (p=0.0051 for OS and p=0.022 for PFS). CONCLUSION: Our retrospective, multi-center study suggests that survival in patients with GBM is not affected by the extent of resection of FLAIR-hyperintense areas.
BACKGROUND: A relationship between the extent of resection (EOR) and survival has been demonstrated in patients with glioblastomas (GBMs). However, despite gross total resection (GTR) of the enhancing nodule (EN), GBMs usually relapse, generally near the surgical cavity. OBJECTIVE: The aim of this study was to determine the prognostic role of FLAIR resection of GBMs by analyzing pre- and post-operative MRIs to estimate the EOR of EN, FLAIR-hyperintense regions and total tumor volume (TTV). METHODS: Radiologic and clinical outcomes were analyzed retrospectively. Pre- and post-operative EN volume, pre- and postoperative FLAIR volume (POFV), and pre- and postoperative TTV were analyzed. EOR was then calculated for each component. Time-dependent ROC curves and cut-off values for pre- and post-operative volumes and EOR were calculated. A Kaplan-Meier analysis with the log-rank test and Cox regression analysis were then used to analyze progression-free survival (PFS) and overall survival (OS). RESULTS: We did not find any correlation between EOR of FLAIR-altered regions and patient survival. On the other hand, there were statistically significant relationships between the prognosis and both a preoperative EN volume less than 31.35 cm3 (p=0.032) and a postoperative EN volume less than 0.57 cm3 (p=0.015). Moreover, an EOR of EN greater than 96% was significantly associated with the prognosis (p=0.0051 for OS and p=0.022 for PFS). CONCLUSION: Our retrospective, multi-center study suggests that survival in patients with GBM is not affected by the extent of resection of FLAIR-hyperintense areas.
Authors: Ashish H Shah; Anil Mahavadi; Long Di; Alexander Sanjurjo; Daniel G Eichberg; Veronica Borowy; Javier Figueroa; Evan Luther; Macarena Ines de la Fuente; Alexa Semonche; Michael E Ivan; Ricardo J Komotar Journal: J Neurooncol Date: 2020-07-05 Impact factor: 4.130
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Authors: Giuseppe Maria Vincenzo Barbagallo; Roberto Altieri; Marco Garozzo; Massimiliano Maione; Stefania Di Gregorio; Massimiliano Visocchi; Simone Peschillo; Pasquale Dolce; Francesco Certo Journal: Front Oncol Date: 2021-02-24 Impact factor: 6.244
Authors: David Kis; Laszlo Szivos; Mark Rekecki; Bayan Salam Shukir; Adrienn Mate; Katalin Hideghety; Pal Barzo Journal: Front Neurosci Date: 2022-09-21 Impact factor: 5.152
Authors: Giuseppe Palmieri; Fabio Cofano; Luca Francesco Salvati; Matteo Monticelli; Pietro Zeppa; Giuseppe Di Perna; Antonio Melcarne; Roberto Altieri; Giuseppe La Rocca; Giovanni Sabatino; Giuseppe Maria Barbagallo; Fulvio Tartara; Francesco Zenga; Diego Garbossa Journal: Technol Cancer Res Treat Date: 2021 Jan-Dec