The impact of surgery on the survival of patients with recurrent glioblastoma

Sacko, Oumar; Benouaich‐Amiel, Alexandra; Brandicourt, Pierre; Niaré, Mahamadou; Charni, Saloua; Cavandoli, Clarissa; Brauge, David; Catalaâ, I.; Brenner, Antônio Sérgio; Moyal, Elizabeth Cohen-Jonathan; Roux, Franck‐Emmanuel

doi:10.4103/ajns.ajns_180_20

Cited by 14 publications

(10 citation statements)

References 40 publications

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“…15 This highlights the need for individualized decision-making based on patient characteristics and tumor features. The literature presently has only opinions and case series for re-surgery, [16][17][18] and a randomized controlled trial is essential.…”

Section: Discussionmentioning

confidence: 99%

Practice Patterns for Managing Recurrent Glioblastoma Multiforme

Bajaj,

Kedia,

Sharma

et al. 2024

Indian Journal of Neurosurgery

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Introduction Glioblastoma multiforme (GBM) is a devastating form of cancer with a poor prognosis despite available treatments. Managing recurrent GBM remains challenging and lacks guidelines. This study aims to provide practice patterns for managing recurrent GBMs in India. Methods A panel of experts was assembled to develop practice patterns using the Delphi technique. Their responses were analyzed anonymously to ensure impartiality and generate recommendations. The statements were intended to be nonbinding and focused on promoting best practices in the field, without legal or regulatory authority. Results A total of 23 experts participated in the study, providing their opinions on various aspects of managing recurrent GBM. Consensus was achieved on individualized and multidisciplinary management as the preferred approach. Surgery in combination with other treatments was found to impact survival in patients older than 65 years, with re-surgery and adjuvant radiation and chemotherapy being the preferred options. Gadolinium-enhanced magnetic resonance imaging (MRI) brain with spectroscopy and diffusion-weighted imaging was favored. Molecular profiling was considered significant, with O6-methylguanine DNA methyltransferase methylation being most relevant. Surgery was recommended for recurrent GBMs, primarily based on Karnofsky's performance score (KPS). Surgical adjuncts such as neuronavigation and intraoperative MRI were considered valuable. Radiation therapy, specifically stereotactic radiosurgery, was recommended for selected cases, while opinions on re-chemotherapy were divided. Palliative care was deemed important. Conclusion This study presents practice patterns for managing recurrent GBM in India, providing standardized recommendations for practice. By implementing these, clinicians can make informed decisions, leading to improved patient outcomes and reduced variability in the management of recurrent GBM.

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Section: Discussionmentioning

confidence: 99%

Practice Patterns for Managing Recurrent Glioblastoma Multiforme

Bajaj,

Kedia,

Sharma

et al. 2024

Indian Journal of Neurosurgery

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“…In recent years, a variety of management strategies for rGBM were explored. Re-resection was proved to be a favorable independently prognostic factor for rGBM [24][25][26][27]. In Ringel's study [9], the median OS of patients who received re-operation without considering IDH1 status was 11.9 months.…”

Section: Discussionmentioning

confidence: 99%

Anlotinib Combined with Temozolomide Therapy for Recurrent Glioblastoma (IDH-wt and TERTp-mut) After Standard Treatment

Wang

Liao

Wang

et al. 2022

Preprint

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Purpose IDH1-wt glioblastoma patients with TERTp-mut had the worst prognosis, and no effective management strategy was established after tumor recurrence. The median overall survival (OS) of recurrent GBM patients who only received supportive therapy was approximately 1.0 month. We reported survival outcomes of recurrent glioblastoma (rGBM) treated with anlotinib combined with temozolomide therapy (ACTT), and to explore the management strategy of rGBM. Methods The clinical data of 14 rGBM patients treated with ACTT was collected. Therapeutic efficacy and adverse effects were evaluated in every 2 months of treatment. We also included 16 patients treated with bevacizumab (Bev), 22 with TMZ, 28 with re-operation, 21 with re-irradiation, and 75 with supportive care to make comparison. Kaplan-Meier analysis was used to compare the survival of ACTT group versus other treatment groups. Results Fourteen rGBM patients treated with ACTT were enrolled. After 2-month of ACTT, the overall response and disease control rate were 50.0% and 92.9%, respectively. The 6-months PFS rate was 78.6%, and the 1-year survival rate was 50.0%. The median PFS and OS in ACTT group were 11.0 and 13.0 months, respectively. The median PFS and OS in Bev-group was 4.0 and 8.0 months. The patients treated with ACTT had better PFS than that in Bev-group. And compared to all the others treatment groups, ACTT could prolong survival. Conclusion The treatment regimen of ACTT maybe reliable, safe, and effective for rGBM. The patients can gain survival benefits from ACTT, and prolonged survival were observed compared with other treatment regimens.

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“…The pooled results from four studies [14], [28], [31], [32] showed a statistically significant ratio of mortality in female as compared to males (HR= 1.19 [1.06, 1.34]; p = 0.002; I 2 = 0%).…”

Section: Effect Of Gender In Prognosis Of Glioblastoma Multiforme Pat...mentioning

confidence: 99%

The Impact of Extent of Resection on the Prognosis of Glioblastoma Multiforme: A Systematic Review and Meta-analysis

Chaulagain

Smolanka

et al. 2022

Open Access Maced J Med Sci

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Purpose: To investigate the predictor factors of mortality describing the prognosis of primary surgical resection of Glioblastoma Multiforme (GBM). Materials and Methods: A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to 12th September 2021. All statistical analysis was conducted in Review Manager 5.4.1. Studies meeting inclusion criteria were selected. A random-effect model was used when heterogeneity was seen to pool the studies, and the result were reported in the Hazards Ratio (HR) and corresponding 95% Confidence interval (CI). Result: Twenty-three cohort studies were selected for meta-analysis. There was statistically significant effect of extent of resection on prognosis of surgery in GBM patients (HR= 0.90 [0.86, 0.95]; p< 0.0001; I2= 96%), male gender (HR= 1.19 [1.06, 1.34]; p= 0.002; I2= 0%) and decrease Karnofsky Performance Status (HR= 0.97 [0.95, 0.99]; p= 0.003; I2= 90%). Age and tumor volume was also analyzed in the study. Conclusion: The results of our meta-analysis suggested that age, gender, pre-operative KPS score and extent of resection have significant effects on the post-surgical mortality rate, therefore, these factors can be used significant predictor of mortality in GBM patients.

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The impact of surgery on the survival of patients with recurrent glioblastoma

Cited by 14 publications

References 40 publications

Practice Patterns for Managing Recurrent Glioblastoma Multiforme

Practice Patterns for Managing Recurrent Glioblastoma Multiforme

Anlotinib Combined with Temozolomide Therapy for Recurrent Glioblastoma (IDH-wt and TERTp-mut) After Standard Treatment

The Impact of Extent of Resection on the Prognosis of Glioblastoma Multiforme: A Systematic Review and Meta-analysis

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