Reoperation for malignant astrocytoma

Abstract

We evaluated 15 consecutive patients with malignant astrocytomas who were reoperated for functional status and survival. Their Karnovsky Performance Status (KPS) was not changed by surgery. None suffered perioperative death, wound infection, or complications. Patients with glioblastoma maintained KPS unchanged for a mean of 13 weeks (median, 10 weeks); with anaplastic astrocytoma, mean, 37.2 weeks (median, 24 weeks). Life spans were approximately twice that of non-reoperated historical controls. Reoperation for patients with recurrent malignant astrocytoma should be seriously considered when a gross total re-resection can be the goal in a patient whose tumor is in an accessible brain region.

Postoperative ischemic changes after glioma resection identified by diffusion-weighted magnetic resonance imaging and their association with intraoperative motor evoked potentials

“…Although in our recent study we identified significant differences between recurrent and newly diagnosed glioma patients with respect to neurological outcome and incidence of postoperative ischemic lesions, there are still few and contradictory data available on the resection of recurrent intrinsic brain tumors. 1,2,4,8,15,19,28,29 Ultimately, even though we were able to detect relevant ischemic events by intraoperative monitoring, the key question remains of how to avoid these events. Certainly a meticulous surgical technique tailored to the vascular architecture at risk, whether cortical arteries and draining veins or subcortical perforating arteries, is the mainstay of a safe resection.…”

Does extent of surgery influence outcome for astrocytoma with atypical or anaplastic foci (AAF)? A report from three Radiation Therapy Oncology Group (RTOG) trials

“…In reviews of both institutional and cooperative group experiences with malignant gliomas, conclusions regarding the influence of aggressive surgery on survival are conflicting. Reports noting a positive correlation include those by Stenning et al [26], Gehan and Walker [27], Chang et al [2], Ammirati et al [28], and Vick et al [29]. Those observing no significant relationship between extent of surgery and survival include studies by Fulton et aI.…”

Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project

“…In selected patients, a repeated operation can be performed. 1,3,15,33 The perioperative complications have been reported to vary both in type and severity in this group for a number of reasons. Some authors have suggested that a repeated operation for malignant glioma is not associated with increased risk, 27,35 some have shown statistically insignificant trends toward increased complications, 6,29 and some have suggested that there clearly is an increased risk.…”