Articles: glioblastoma-surgery.
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Multicenter Study
Which Parameter Is More Important for the Prognosis of New-Onset Adult Glioblastoma: Residual Tumor Volume or Extent of Resection?
The extent of resection (EOR) and residual tumor volume (RTV) are 2 pivotal predictors influencing the survival of patients with new-onset adult glioblastoma. Which of these 2 factors is more important remains unclear, however. The present aimed to evaluate and compare the accuracy of EOR and RTV, based on contrast-enhancing (CE) T1-weighted magnetic resonance imaging (MRI) and T2-weighted/fluid-attenuated inversion recovery (F) MRI, as prognostic factors in these patients. ⋯ Regardless of total or partial CE tumor resection, EOR might not be an independent prognostic factor. In contrast, RTV has the potential to offer greater predictive power for the prognosis of new-onset adult glioblastoma. Further investigations of the correlations of RTV and EOR with survival in patients with new-onset glioblastoma are needed.
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Multicenter Study Comparative Study
Is there an indication of intraoperative MRI in subtotal resection of glioblastoma? - A multicenter retrospective comparative analysis.
Surgery in patients with highly eloquent glioblastoma (GB) remains challenging. The aim of this study was to evaluate influence of use of intraoperative magnetic resonance imaging (iMRI) on extent of resection (EOR), clinical outcome, and survival in patients with preoperatively intended subtotal resection of GB. ⋯ Maximum safe resection is an important prognostic factor for patients with eloquent GBs. iMRI seems to be a relevant tool to achieve this goal.
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While standards for the treatment of newly diagnosed glioblastomas exist, therapeutic regimens for tumor recurrence remain mostly individualized. The role of a surgical resection of recurrent glioblastomas remains largely unclear at present. This study aimed to assess the effect of repeated resection of recurrent glioblastomas on patient survival. ⋯ The present study supports the view that surgical resections of recurrent glioblastomas may help to prolong patient survival at an acceptable complication rate.
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Multicenter Study Comparative Study
Extent of resection of glioblastoma revisited: personalized survival modeling facilitates more accurate survival prediction and supports a maximum-safe-resection approach to surgery.
Approximately 12,000 glioblastomas are diagnosed annually in the United States. The median survival rate for this disease is 12 months, but individual survival rates can vary with patient-specific factors, including extent of surgical resection (EOR). The goal of our investigation is to develop a reliable strategy for personalized survival prediction and for quantifying the relationship between survival, EOR, and adjuvant chemoradiotherapy. ⋯ Nonlinear, multivariable AFT modeling outperforms current methods for estimating individual survival after glioblastoma resection. The model produces personalized survival curves and quantifies the relationship between variables modulating patient-specific survival. This approach provides comprehensive, personalized, probabilistic, and clinically relevant information regarding the anticipated course of disease, the overall prognosis, and the patient-specific influence of EOR and adjuvant chemoradiotherapy. The continuous, nonlinear relationship identified between expected median survival and EOR argues against a surgical management strategy based on rigid EOR thresholds and instead provides the first explicit evidence supporting a maximum safe resection approach to glioblastoma surgery.
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Multicenter Study Observational Study
Gross total but not incomplete resection of glioblastoma prolongs survival in the era of radiochemotherapy.
This prospective multicenter study assessed the prognostic influence of the extent of resection when compared with biopsy only in a contemporary patient population with newly diagnosed glioblastoma. ⋯ The value of incomplete resection remains questionable. If GTR cannot be safely achieved, biopsy only might be used as an alternative surgical strategy.