PURPOSE: Extent of resection remains a paramount prognostic factor for long-term outcomes for glioblastoma. As such, supramaximal resection or anatomic lobectomy have been offered for non-eloquent glioblastoma in an attempt to improve overall survival. Here, we conduct a propensity-matched analysis of patients with non-eloquent glioblastoma who underwent either lobectomy or gross total resection of lesion to investigate the efficacy of supramaximal resection of glioblastoma. METHODS: Patients who underwent initial surgery for gross total resection or lobectomy for non-eloquent glioblastoma at our tertiary care referral center from 2010 to 2019 were included for this propensity-matched survival analysis. Propensity scores were generated with the following covariates: age, location, preoperative KPS, product of perpendicular maximal tumor diameters, and product of perpendicular FLAIR signal diameters. Inverse probability of treatment weighting (IPTW) with generated propensity scores was used to compare progression-free survival and overall survival. RESULTS: Sixty-nine patients were identified who underwent initial resection of glioblastoma for non-eloquent glioblastoma from 2010 to 2019 (GTR = 37, lobectomy = 32). Using IPTW, overall survival (30.7 vs. 14.1 months) and progression-free survival (17.2 vs. 8.1 months were significantly higher in the lobectomy cohort compared to the GTR group (p < 0.001). There was no significant difference in pre-op or post-op KPS or complication rates between the two groups. CONCLUSION: Our propensity-matched study suggests that lobectomy for non-eloquent glioblastoma confers an added survival benefit compared to GTR alone. For patients with non-eloquent glioblastoma, a supramaximal resection by means of an anatomic lobectomy should be considered as a primary surgical treatment in select patients if feasible.
PURPOSE: Extent of resection remains a paramount prognostic factor for long-term outcomes for glioblastoma. As such, supramaximal resection or anatomic lobectomy have been offered for non-eloquent glioblastoma in an attempt to improve overall survival. Here, we conduct a propensity-matched analysis of patients with non-eloquent glioblastoma who underwent either lobectomy or gross total resection of lesion to investigate the efficacy of supramaximal resection of glioblastoma. METHODS:Patients who underwent initial surgery for gross total resection or lobectomy for non-eloquent glioblastoma at our tertiary care referral center from 2010 to 2019 were included for this propensity-matched survival analysis. Propensity scores were generated with the following covariates: age, location, preoperative KPS, product of perpendicular maximal tumor diameters, and product of perpendicular FLAIR signal diameters. Inverse probability of treatment weighting (IPTW) with generated propensity scores was used to compare progression-free survival and overall survival. RESULTS: Sixty-nine patients were identified who underwent initial resection of glioblastoma for non-eloquent glioblastoma from 2010 to 2019 (GTR = 37, lobectomy = 32). Using IPTW, overall survival (30.7 vs. 14.1 months) and progression-free survival (17.2 vs. 8.1 months were significantly higher in the lobectomy cohort compared to the GTR group (p < 0.001). There was no significant difference in pre-op or post-op KPS or complication rates between the two groups. CONCLUSION: Our propensity-matched study suggests that lobectomy for non-eloquent glioblastoma confers an added survival benefit compared to GTR alone. For patients with non-eloquent glioblastoma, a supramaximal resection by means of an anatomic lobectomy should be considered as a primary surgical treatment in select patients if feasible.
Entities:
Keywords:
Brain tumor; Glioma; Gross total resection; Lobectomy; Outcomes
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Authors: Tito Vivas-Buitrago; Ricardo A Domingo; Shashwat Tripathi; Gaetano De Biase; Desmond Brown; Oluwaseun O Akinduro; Andres Ramos-Fresnedo; David S Sabsevitz; Bernard R Bendok; Wendy Sherman; Ian F Parney; Mark E Jentoft; Erik H Middlebrooks; Fredric B Meyer; Kaisorn L Chaichana; Alfredo Quinones-Hinojosa Journal: J Neurosurg Date: 2021-06-04 Impact factor: 5.408
Authors: Jawad Fares; Atique U Ahmed; Ilya V Ulasov; Adam M Sonabend; Jason Miska; Catalina Lee-Chang; Irina V Balyasnikova; James P Chandler; Jana Portnow; Matthew C Tate; Priya Kumthekar; Rimas V Lukas; Sean A Grimm; Ann K Adams; Charles D Hébert; Theresa V Strong; Christina Amidei; Victor A Arrieta; Markella Zannikou; Craig Horbinski; Hui Zhang; Kirsten Bell Burdett; David T Curiel; Sean Sachdev; Karen S Aboody; Roger Stupp; Maciej S Lesniak Journal: Lancet Oncol Date: 2021-06-29 Impact factor: 54.433
Authors: Cassandra P Griffin; Christine L Paul; Kimberley L Alexander; Marjorie M Walker; Hubert Hondermarck; James Lynam Journal: Neurooncol Adv Date: 2021-11-18