OBJECTIVE: The authors' goal was to use a multicenter, observational cohort study to determine whether supramarginal resection (SMR) of FLAIR-hyperintense tumor beyond the contrast-enhanced (CE) area influences the overall survival (OS) of patients with isocitrate dehydrogenase-wild-type (IDH-wt) glioblastoma after gross-total resection (GTR). METHODS: The medical records of 888 patients aged ≥ 18 years who underwent resection of GBM between January 2011 and December 2017 were reviewed. Volumetric measurements of the CE tumor and surrounding FLAIR-hyperintense tumor were performed, clinical variables were obtained, and associations with OS were analyzed. RESULTS: In total, 101 patients with newly diagnosed IDH-wt GBM who underwent GTR of the CE tumor met the inclusion criteria. In multivariate analysis, age ≥ 65 years (HR 1.97; 95% CI 1.01-2.56; p < 0.001) and contact with the lateral ventricles (HR 1.59; 95% CI 1.13-1.78; p = 0.025) were associated with shorter OS, but preoperative Karnofsky Performance Status ≥ 70 (HR 0.47; 95% CI 0.27-0.89; p = 0.006), MGMT promotor methylation (HR 0.63; 95% CI 0.52-0.99; p = 0.044), and increased percentage of SMR (HR 0.99; 95% CI 0.98-0.99; p = 0.02) were associated with longer OS. Finally, 20% SMR was the minimum percentage associated with beneficial OS (HR 0.56; 95% CI 0.35-0.89; p = 0.01), but > 60% SMR had no significant influence (HR 0.74; 95% CI 0.45-1.21; p = 0.234). CONCLUSIONS: SMR is associated with improved OS in patients with IDH-wt GBM who undergo GTR of CE tumor. At least 20% SMR of the CE tumor was associated with beneficial OS, but greater than 60% SMR had no significant influence on OS.
OBJECTIVE: The authors' goal was to use a multicenter, observational cohort study to determine whether supramarginal resection (SMR) of FLAIR-hyperintense tumor beyond the contrast-enhanced (CE) area influences the overall survival (OS) of patients with isocitrate dehydrogenase-wild-type (IDH-wt) glioblastoma after gross-total resection (GTR). METHODS: The medical records of 888 patients aged ≥ 18 years who underwent resection of GBM between January 2011 and December 2017 were reviewed. Volumetric measurements of the CE tumor and surrounding FLAIR-hyperintense tumor were performed, clinical variables were obtained, and associations with OS were analyzed. RESULTS: In total, 101 patients with newly diagnosed IDH-wt GBM who underwent GTR of the CE tumor met the inclusion criteria. In multivariate analysis, age ≥ 65 years (HR 1.97; 95% CI 1.01-2.56; p < 0.001) and contact with the lateral ventricles (HR 1.59; 95% CI 1.13-1.78; p = 0.025) were associated with shorter OS, but preoperative Karnofsky Performance Status ≥ 70 (HR 0.47; 95% CI 0.27-0.89; p = 0.006), MGMT promotor methylation (HR 0.63; 95% CI 0.52-0.99; p = 0.044), and increased percentage of SMR (HR 0.99; 95% CI 0.98-0.99; p = 0.02) were associated with longer OS. Finally, 20% SMR was the minimum percentage associated with beneficial OS (HR 0.56; 95% CI 0.35-0.89; p = 0.01), but > 60% SMR had no significant influence (HR 0.74; 95% CI 0.45-1.21; p = 0.234). CONCLUSIONS: SMR is associated with improved OS in patients with IDH-wt GBM who undergo GTR of CE tumor. At least 20% SMR of the CE tumor was associated with beneficial OS, but greater than 60% SMR had no significant influence on OS.
Authors: Francesco Certo; Walter Stummer; Jibril O Farah; Christian Freyschlag; Massimiliano Visocchi; Antonio Morrone; Roberto Altieri; Giada Toccaceli; Simone Peschillo; Claudius Thomè; Michael Jenkinson; Giuseppe Barbagallo Journal: J Neurosurg Sci Date: 2019-07-29 Impact factor: 2.279
Authors: Anteneh M Feyissa; Gregory A Worrell; William O Tatum; Deependra Mahato; Benjamin H Brinkmann; Steven S Rosenfeld; Karim ReFaey; Perry S Bechtle; Alfredo Quinones-Hinojosa Journal: Neurology Date: 2018-02-28 Impact factor: 9.910
Authors: Matthew J McGirt; Debraj Mukherjee; Kaisorn L Chaichana; Khoi D Than; Jon D Weingart; Alfredo Quinones-Hinojosa Journal: Neurosurgery Date: 2009-09 Impact factor: 4.654
Authors: Shashwat Tripathi; Tito Vivas-Buitrago; Ricardo A Domingo; Gaetano De Biase; Desmond Brown; Oluwaseun O Akinduro; Andres Ramos-Fresnedo; Wendy Sherman; Vivek Gupta; Erik H Middlebrooks; David S Sabsevitz; Alyx B Porter; Joon H Uhm; Bernard R Bendok; Ian Parney; Fredric B Meyer; Kaisorn L Chaichana; Kristin R Swanson; Alfredo Quiñones-Hinojosa Journal: J Neurosurg Date: 2021-10-29 Impact factor: 5.408
Authors: Emily S Norton; Lauren A Whaley; María José Ulloa-Navas; Patricia García-Tárraga; Kayleah M Meneses; Montserrat Lara-Velazquez; Natanael Zarco; Anna Carrano; Alfredo Quiñones-Hinojosa; José Manuel García-Verdugo; Hugo Guerrero-Cázares Journal: Fluids Barriers CNS Date: 2022-07-11