Complete and Incomplete Resection for Progressive Glioblastoma Prolongs Post-Progression Survival
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Complete and Incomplete Resection for Progressive Glioblastoma Prolongs Post-Progression Survival. / Behling, Felix; Rang, Julia; Dangel, Elena; Noell, Susan; Renovanz, Mirjam; Mäurer, Irina; Schittenhelm, Jens; Bender, Benjamin; Paulsen, Frank; Brendel, Bettina; Martus, Peter; Gempt, Jens; Barz, Melanie; Meyer, Bernhard; Tatagiba, Marcos; Skardelly, Marco.
In: FRONT ONCOL, Vol. 12, 2022, p. 755430.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Complete and Incomplete Resection for Progressive Glioblastoma Prolongs Post-Progression Survival
AU - Behling, Felix
AU - Rang, Julia
AU - Dangel, Elena
AU - Noell, Susan
AU - Renovanz, Mirjam
AU - Mäurer, Irina
AU - Schittenhelm, Jens
AU - Bender, Benjamin
AU - Paulsen, Frank
AU - Brendel, Bettina
AU - Martus, Peter
AU - Gempt, Jens
AU - Barz, Melanie
AU - Meyer, Bernhard
AU - Tatagiba, Marcos
AU - Skardelly, Marco
N1 - Copyright © 2022 Behling, Rang, Dangel, Noell, Renovanz, Mäurer, Schittenhelm, Bender, Paulsen, Brendel, Martus, Gempt, Barz, Meyer, Tatagiba and Skardelly.
PY - 2022
Y1 - 2022
N2 - OBJECTIVE: The role of resection in progressive glioblastoma (GBM) to prolong survival is still controversial. The aim of this study was to determine 1) the predictors of post-progression survival (PPS) in progressive GBM and 2) which subgroups of patients would benefit from recurrent resection.METHODS: We have conducted a retrospective bicentric cohort study on isocitrate dehydrogenase (IDH) wild-type GBM treated in our hospitals between 2006 and 2015. Kaplan-Maier analyses and univariable and multivariable Cox regressions were performed to identify predictors and their influence on PPS.RESULTS: Of 589 patients with progressive IDH wild-type GBM, 355 patients were included in analyses. Median PPS of all patients was 9 months (95% CI 8.0-10.0), with complete resection 12 months (95% CI 9.7-14.3, n=81), incomplete resection 11 months (95% CI 8.9-13.1, n=70) and without resection 7 months (95% CI 06-08, n=204). Multivariable Cox regression demonstrated a benefit for PPS with complete (HR 0.67, CI 0.49-0.90) and incomplete resection (HR 0.73, 95% CI 0.51-1.04) and confirmed methylation of the O6-methylguanine-DNA-methyltransferase (MGMT) gene promoter, lower age at diagnosis, absence of deep brain and multilocular localization, higher Karnofsky Performance Status (KPS) and recurrent therapies to be associated with longer PPS. In contrast, traditional eloquence and duration of progression-free survival had no effect on PPS. Subgroup analyses showed that all subgroups of confirmed predictors benefited from resection, except for patients in poor condition with a KPS <70.CONCLUSIONS: Out data suggest a role for complete and incomplete recurrent resection in progressive GBM patients regardless of methylation of MGMT, age, or adjuvant therapy but not in patients with a poor clinical condition with a KPS <70.
AB - OBJECTIVE: The role of resection in progressive glioblastoma (GBM) to prolong survival is still controversial. The aim of this study was to determine 1) the predictors of post-progression survival (PPS) in progressive GBM and 2) which subgroups of patients would benefit from recurrent resection.METHODS: We have conducted a retrospective bicentric cohort study on isocitrate dehydrogenase (IDH) wild-type GBM treated in our hospitals between 2006 and 2015. Kaplan-Maier analyses and univariable and multivariable Cox regressions were performed to identify predictors and their influence on PPS.RESULTS: Of 589 patients with progressive IDH wild-type GBM, 355 patients were included in analyses. Median PPS of all patients was 9 months (95% CI 8.0-10.0), with complete resection 12 months (95% CI 9.7-14.3, n=81), incomplete resection 11 months (95% CI 8.9-13.1, n=70) and without resection 7 months (95% CI 06-08, n=204). Multivariable Cox regression demonstrated a benefit for PPS with complete (HR 0.67, CI 0.49-0.90) and incomplete resection (HR 0.73, 95% CI 0.51-1.04) and confirmed methylation of the O6-methylguanine-DNA-methyltransferase (MGMT) gene promoter, lower age at diagnosis, absence of deep brain and multilocular localization, higher Karnofsky Performance Status (KPS) and recurrent therapies to be associated with longer PPS. In contrast, traditional eloquence and duration of progression-free survival had no effect on PPS. Subgroup analyses showed that all subgroups of confirmed predictors benefited from resection, except for patients in poor condition with a KPS <70.CONCLUSIONS: Out data suggest a role for complete and incomplete recurrent resection in progressive GBM patients regardless of methylation of MGMT, age, or adjuvant therapy but not in patients with a poor clinical condition with a KPS <70.
U2 - 10.3389/fonc.2022.755430
DO - 10.3389/fonc.2022.755430
M3 - SCORING: Journal article
C2 - 35251956
VL - 12
SP - 755430
JO - FRONT ONCOL
JF - FRONT ONCOL
SN - 2234-943X
ER -
