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Impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups

BACKGROUND: The impact of extent of resection (EOR), residual tumor volume (RTV), and gross-total resection (GTR) in glioblastoma subgroups is currently unknown. This study aimed to analyze their impact on patient subgroups in relation to neurological and functional outcomes. METHODS: Patients with...

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Autores principales: Gerritsen, Jasper K W, Zwarthoed, Rosa H, Kilgallon, John L, Nawabi, Noah Lee, Versyck, Georges, Jessurun, Charissa A C, Pruijn, Koen P, Fisher, Fleur L, Larivière, Emma, Solie, Lien, Mekary, Rania A, Satoer, Djaina D, Schouten, Joost W, Bos, Eelke M, Kloet, Alfred, Tewarie, Rishi Nandoe, Smith, Timothy R, Dirven, Clemens M F, De Vleeschouwer, Steven, Vincent, Arnaud J P E, Broekman, Marike L D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158118/
https://www.ncbi.nlm.nih.gov/pubmed/36420703
http://dx.doi.org/10.1093/neuonc/noac255
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author Gerritsen, Jasper K W
Zwarthoed, Rosa H
Kilgallon, John L
Nawabi, Noah Lee
Versyck, Georges
Jessurun, Charissa A C
Pruijn, Koen P
Fisher, Fleur L
Larivière, Emma
Solie, Lien
Mekary, Rania A
Satoer, Djaina D
Schouten, Joost W
Bos, Eelke M
Kloet, Alfred
Tewarie, Rishi Nandoe
Smith, Timothy R
Dirven, Clemens M F
De Vleeschouwer, Steven
Vincent, Arnaud J P E
Broekman, Marike L D
author_facet Gerritsen, Jasper K W
Zwarthoed, Rosa H
Kilgallon, John L
Nawabi, Noah Lee
Versyck, Georges
Jessurun, Charissa A C
Pruijn, Koen P
Fisher, Fleur L
Larivière, Emma
Solie, Lien
Mekary, Rania A
Satoer, Djaina D
Schouten, Joost W
Bos, Eelke M
Kloet, Alfred
Tewarie, Rishi Nandoe
Smith, Timothy R
Dirven, Clemens M F
De Vleeschouwer, Steven
Vincent, Arnaud J P E
Broekman, Marike L D
author_sort Gerritsen, Jasper K W
collection PubMed
description BACKGROUND: The impact of extent of resection (EOR), residual tumor volume (RTV), and gross-total resection (GTR) in glioblastoma subgroups is currently unknown. This study aimed to analyze their impact on patient subgroups in relation to neurological and functional outcomes. METHODS: Patients with tumor resection for eloquent glioblastoma between 2010 and 2020 at 4 tertiary centers were recruited from a cohort of 3919 patients. RESULTS: One thousand and forty-seven (1047) patients were included. Higher EOR and lower RTV were significantly associated with improved overall survival (OS) and progression-free survival (PFS) across all subgroups, but RTV was a stronger prognostic factor. GTR based on RTV improved median OS in the overall cohort (19.0 months, P < .0001), and in the subgroups with IDH wildtype tumors (18.5 months, P = .00055), MGMT methylated tumors (35.0 months, P < .0001), aged <70 (20.0 months, P < .0001), NIHSS 0–1 (19.0 months, P = .0038), KPS 90–100 (19.5 months, P = .0012), and KPS ≤80 (17.0 months, P = .036). GTR was significantly associated with improved OS in the overall cohort (HR 0.58, P = .0070) and improved PFS in the NIHSS 0–1 subgroup (HR 0.47, P = .012). GTR combined with preservation of neurological function (OFO 1 grade) yielded the longest survival times (median OS 22.0 months, P < .0001), which was significantly more frequently achieved in the awake mapping group (50.0%) than in the asleep group (21.8%) (P < .0001). CONCLUSIONS: Maximum resection was especially beneficial in the subgroups aged <70, NIHSS 0–1, and KPS 90–100 without increasing the risk of postoperative NIHSS or KPS worsening. These findings may assist surgical decision making in individual glioblastoma patients.
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spelling pubmed-101581182023-05-05 Impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups Gerritsen, Jasper K W Zwarthoed, Rosa H Kilgallon, John L Nawabi, Noah Lee Versyck, Georges Jessurun, Charissa A C Pruijn, Koen P Fisher, Fleur L Larivière, Emma Solie, Lien Mekary, Rania A Satoer, Djaina D Schouten, Joost W Bos, Eelke M Kloet, Alfred Tewarie, Rishi Nandoe Smith, Timothy R Dirven, Clemens M F De Vleeschouwer, Steven Vincent, Arnaud J P E Broekman, Marike L D Neuro Oncol Clinical Investigations BACKGROUND: The impact of extent of resection (EOR), residual tumor volume (RTV), and gross-total resection (GTR) in glioblastoma subgroups is currently unknown. This study aimed to analyze their impact on patient subgroups in relation to neurological and functional outcomes. METHODS: Patients with tumor resection for eloquent glioblastoma between 2010 and 2020 at 4 tertiary centers were recruited from a cohort of 3919 patients. RESULTS: One thousand and forty-seven (1047) patients were included. Higher EOR and lower RTV were significantly associated with improved overall survival (OS) and progression-free survival (PFS) across all subgroups, but RTV was a stronger prognostic factor. GTR based on RTV improved median OS in the overall cohort (19.0 months, P < .0001), and in the subgroups with IDH wildtype tumors (18.5 months, P = .00055), MGMT methylated tumors (35.0 months, P < .0001), aged <70 (20.0 months, P < .0001), NIHSS 0–1 (19.0 months, P = .0038), KPS 90–100 (19.5 months, P = .0012), and KPS ≤80 (17.0 months, P = .036). GTR was significantly associated with improved OS in the overall cohort (HR 0.58, P = .0070) and improved PFS in the NIHSS 0–1 subgroup (HR 0.47, P = .012). GTR combined with preservation of neurological function (OFO 1 grade) yielded the longest survival times (median OS 22.0 months, P < .0001), which was significantly more frequently achieved in the awake mapping group (50.0%) than in the asleep group (21.8%) (P < .0001). CONCLUSIONS: Maximum resection was especially beneficial in the subgroups aged <70, NIHSS 0–1, and KPS 90–100 without increasing the risk of postoperative NIHSS or KPS worsening. These findings may assist surgical decision making in individual glioblastoma patients. Oxford University Press 2022-11-24 /pmc/articles/PMC10158118/ /pubmed/36420703 http://dx.doi.org/10.1093/neuonc/noac255 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Investigations
Gerritsen, Jasper K W
Zwarthoed, Rosa H
Kilgallon, John L
Nawabi, Noah Lee
Versyck, Georges
Jessurun, Charissa A C
Pruijn, Koen P
Fisher, Fleur L
Larivière, Emma
Solie, Lien
Mekary, Rania A
Satoer, Djaina D
Schouten, Joost W
Bos, Eelke M
Kloet, Alfred
Tewarie, Rishi Nandoe
Smith, Timothy R
Dirven, Clemens M F
De Vleeschouwer, Steven
Vincent, Arnaud J P E
Broekman, Marike L D
Impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups
title Impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups
title_full Impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups
title_fullStr Impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups
title_full_unstemmed Impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups
title_short Impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups
title_sort impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups
topic Clinical Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158118/
https://www.ncbi.nlm.nih.gov/pubmed/36420703
http://dx.doi.org/10.1093/neuonc/noac255
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