Articles: glioblastoma-surgery.
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Meta Analysis
Extent of resection and survival in patients with glioblastoma multiforme: Systematic review and meta-analysis.
Glioblastoma multiforme (GBM) owes an ominous prognosis: its mean overall survival is 14 months. The extent of surgical resection (ESR) highlights among factors in which an association has been found to a somewhat better prognosis. However, the association between greater ESR and prolonged overall (OS) survival is not a constant finding nor a proven cause-and-effect phenomenon. To our objective is to establish the strength of association between ESR and OS in patients with GBM through a systematic review and meta-analysis. ⋯ Our results sustain a weak but statistically significant association between the ESR and OS in patients with GBM obtained from observational studies with a very low level of evidence according to GRADE criteria. As a consequence, any estimate of effect is very uncertain. Current information cannot sustain a cause-and-effect relationship between these variables.
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Review Meta Analysis
Survival benefit of maximal resection for glioblastoma reoperation in the temozolomide era: a meta-analysis.
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. ⋯ 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.
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Review Meta Analysis
Association Between Supratotal Glioblastoma Resection and Patient Survival: A Systematic Review and Meta-Analysis.
Gross total resection (GTR) of the contrast enhancing (CE) area will improve the survival of patients with glioblastoma (GBM). However, GBM can infiltrate into the brain parenchyma, beyond the CE margins. It remains unclear whether resection beyond the CE area (supratotal resection [SPTR]) can improve survival without causing additional neurological deficits. The aim of the present meta-analysis was to study the association between SPTR and overall survival of patients of GBM. ⋯ Compared with GTR, SPTR of GBM resulted in a lower risk of mortality and longer median overall survival. However, the quality of evidence of the available studies was poor. Therefore, it remains unclear whether SPTR is safe and actually improves the survival of patients with GBM. Future prospective trials and a standardized definition of SPTR are needed.
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Meta Analysis
Prognostic implications of resection extent for patients with glioblastoma multiforme: a meta-analysis.
Surgery is the primary treatment of glioblastoma multiforme (GBM), and a greater extent of resection (EOR) has been shown to be associated with improved survival. Our objective was to perform a meta-analysis comparing the 1-year overall survival (OS) and 1-year progression-free survival (PFS) of GBM patients who receive total resection, incomplete resection, or biopsy only. ⋯ Total resection of GBM is associated with improved OS and PFS as compared to incomplete resection or biopsy.
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Review Meta Analysis
Association of the Extent of Resection With Survival in Glioblastoma: A Systematic Review and Meta-analysis.
Glioblastoma multiforme (GBM) remains almost invariably fatal despite optimal surgical and medical therapy. The association between the extent of tumor resection (EOR) and outcome remains undefined, notwithstanding many relevant studies. ⋯ This analysis represents the largest systematic review and only quantitative systematic review to date performed on this subject. Compared with STR, GTR substantially improves overall and progression-free survival, but the quality of the supporting evidence is moderate to low.