TY - JOUR
T1 - Supratotal resection of glioblastoma
T2 - Is less more?
AU - Altieri, Roberto
AU - Zeppa, Pietro
AU - Melcarne, Antonio
AU - Tardivo, Valentina
AU - Soffietti, Riccardo
AU - Mantovan, Cristina
AU - Rudà, Roberta
AU - Chiovatero, Ilaria
AU - Franchino, Federica
AU - Martini, Stefania
AU - Pellerino, Alessia
AU - Dolce, Pasquale
AU - LA ROCCA, Giuseppe
AU - Savastano, Riccardo
AU - Sabatino, Giovanni
AU - Lanotte, Michele Maria
AU - Olivi, Alessandro
AU - Zenga, Francesco
AU - Ducati, Alessandro
AU - Garbossa, Diego
N1 - Publisher Copyright:
© 2019, Universal Medical Press. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Background: A relationship between the extent of resection (EOR) and survival has been demonstrated in patients with glioblastomas (GBMs). However, despite gross total resection (GTR) of the enhancing nodule (EN),GBMs usually relapse, generally near the surgical cavity. Objective: The aim of this study was to determine the prognostic role of FLAIR resection of GBMs by analyzing pre-and post-operative MRIs to estimate the EOR of EN,FLAIR-hyperintense regions and total tumor volume (TTV). Methods: Radiologic and clinical outcomes were analyzed retrospectively. Pre-and post-operative EN volume, pre-and postoperative FLAIR volume (POFV), and pre-and postoperative TTV were analyzed. EOR was then calculated for each component. Time-dependent ROC curves and cut-off values for pre-and post-operative volumes and EOR were calculated.A Kaplan-Meier analysis with the log-rank test and Cox regression analysis were then used to analyze progression-free survival (PFS) and overall survival (OS). Results: We did not find any correlation between EOR of FLAIR-altered regions and patient survival.On the other hand,there were statistically significant relationships between the prognosis and both a preoperative EN volume less than 31.35 cm3 (p=0.032) and a postoperative EN volume less than 0.57 cm3 (p=0.015).Moreover, an EOR of EN greater than 96% was significantly associated with the prognosis (p=0.0051 for OS and p=0.022 for PFS). Conclusion: Our retrospective, multi-center study suggests that survival in patients with GBM is not affected by the extent of resection of FLAIR-hyperintense areas.
AB - Background: A relationship between the extent of resection (EOR) and survival has been demonstrated in patients with glioblastomas (GBMs). However, despite gross total resection (GTR) of the enhancing nodule (EN),GBMs usually relapse, generally near the surgical cavity. Objective: The aim of this study was to determine the prognostic role of FLAIR resection of GBMs by analyzing pre-and post-operative MRIs to estimate the EOR of EN,FLAIR-hyperintense regions and total tumor volume (TTV). Methods: Radiologic and clinical outcomes were analyzed retrospectively. Pre-and post-operative EN volume, pre-and postoperative FLAIR volume (POFV), and pre-and postoperative TTV were analyzed. EOR was then calculated for each component. Time-dependent ROC curves and cut-off values for pre-and post-operative volumes and EOR were calculated.A Kaplan-Meier analysis with the log-rank test and Cox regression analysis were then used to analyze progression-free survival (PFS) and overall survival (OS). Results: We did not find any correlation between EOR of FLAIR-altered regions and patient survival.On the other hand,there were statistically significant relationships between the prognosis and both a preoperative EN volume less than 31.35 cm3 (p=0.032) and a postoperative EN volume less than 0.57 cm3 (p=0.015).Moreover, an EOR of EN greater than 96% was significantly associated with the prognosis (p=0.0051 for OS and p=0.022 for PFS). Conclusion: Our retrospective, multi-center study suggests that survival in patients with GBM is not affected by the extent of resection of FLAIR-hyperintense areas.
UR - https://www.scopus.com/pages/publications/85087876884
UR - https://www.scopus.com/pages/publications/85087876884#tab=citedBy
M3 - Article
C2 - 31373379
AN - SCOPUS:85087876884
SN - 1090-3941
VL - 35
SP - 1
EP - 9
JO - Surgical technology international
JF - Surgical technology international
ER -