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Clinical Outcome of Cytoreductive Surgery Prior to Bevacizumab for Patients with Recurrent Glioblastoma: A Single-center Retrospective Analysis

Bevacizumab (BEV) is a key anti-angiogenic agent used in the treatment for recurrent glioblastoma multiforme (GBM). The aim of this study was to investigate whether cytoreductive surgery prior to treatment with BEV contributes to prolongation of survival for patients with recurrent GBM. We retrospec...

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Autores principales: YAMAGUCHI, Shigeru, MOTEGI, Hiroaki, ISHI, Yukitomo, OKAMOTO, Michinari, SAWAYA, Ryosuke, KOBAYASHI, Hiroyuki, TERASAKA, Shunsuke, HOUKIN, Kiyohiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048115/
https://www.ncbi.nlm.nih.gov/pubmed/33658457
http://dx.doi.org/10.2176/nmc.oa.2020-0308
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author YAMAGUCHI, Shigeru
MOTEGI, Hiroaki
ISHI, Yukitomo
OKAMOTO, Michinari
SAWAYA, Ryosuke
KOBAYASHI, Hiroyuki
TERASAKA, Shunsuke
HOUKIN, Kiyohiro
author_facet YAMAGUCHI, Shigeru
MOTEGI, Hiroaki
ISHI, Yukitomo
OKAMOTO, Michinari
SAWAYA, Ryosuke
KOBAYASHI, Hiroyuki
TERASAKA, Shunsuke
HOUKIN, Kiyohiro
author_sort YAMAGUCHI, Shigeru
collection PubMed
description Bevacizumab (BEV) is a key anti-angiogenic agent used in the treatment for recurrent glioblastoma multiforme (GBM). The aim of this study was to investigate whether cytoreductive surgery prior to treatment with BEV contributes to prolongation of survival for patients with recurrent GBM. We retrospectively analyzed the treatment outcomes of 124 patients with recurrent GBM who were initially treated with the Stupp protocol between 2006 and 2019. Given that BEV has only been available in Japan since 2013, we grouped the patients into two groups according to the time of first recurrence: the pre-BEV group (N = 51) included patients who had recurrence before BEV approval, and the BEV group (N = 73) included patients with recurrence after BEV approval. The overall survival after first recurrence (OS-R) was analyzed according to the treatment strategy. Among 124 patients, 27 patients (19.4%) received cytoreductive surgery. There were nine cases in the pre-BEV group and 18 cases in the BEV group. Although the mean extent of resection for both groups was almost equal, OS-R was significantly different. The median OS-R was 8.1 m in the pre-BEV group and 16.3 m in the BEV group (P = 0.007). Multivariate analysis revealed that the unavailability of BEV postoperatively (P = 0.03) and decreasing performance status by surgery (P = 0.01) were significant poor prognostic factors for survival after surgery. With the advent of BEV, cytoreductive surgery might provide superior survival benefit at the time of GBM recurrence, especially in cases where surgery can be performed without deteriorating the patient’s condition.
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spelling pubmed-80481152021-04-19 Clinical Outcome of Cytoreductive Surgery Prior to Bevacizumab for Patients with Recurrent Glioblastoma: A Single-center Retrospective Analysis YAMAGUCHI, Shigeru MOTEGI, Hiroaki ISHI, Yukitomo OKAMOTO, Michinari SAWAYA, Ryosuke KOBAYASHI, Hiroyuki TERASAKA, Shunsuke HOUKIN, Kiyohiro Neurol Med Chir (Tokyo) Original Article Bevacizumab (BEV) is a key anti-angiogenic agent used in the treatment for recurrent glioblastoma multiforme (GBM). The aim of this study was to investigate whether cytoreductive surgery prior to treatment with BEV contributes to prolongation of survival for patients with recurrent GBM. We retrospectively analyzed the treatment outcomes of 124 patients with recurrent GBM who were initially treated with the Stupp protocol between 2006 and 2019. Given that BEV has only been available in Japan since 2013, we grouped the patients into two groups according to the time of first recurrence: the pre-BEV group (N = 51) included patients who had recurrence before BEV approval, and the BEV group (N = 73) included patients with recurrence after BEV approval. The overall survival after first recurrence (OS-R) was analyzed according to the treatment strategy. Among 124 patients, 27 patients (19.4%) received cytoreductive surgery. There were nine cases in the pre-BEV group and 18 cases in the BEV group. Although the mean extent of resection for both groups was almost equal, OS-R was significantly different. The median OS-R was 8.1 m in the pre-BEV group and 16.3 m in the BEV group (P = 0.007). Multivariate analysis revealed that the unavailability of BEV postoperatively (P = 0.03) and decreasing performance status by surgery (P = 0.01) were significant poor prognostic factors for survival after surgery. With the advent of BEV, cytoreductive surgery might provide superior survival benefit at the time of GBM recurrence, especially in cases where surgery can be performed without deteriorating the patient’s condition. The Japan Neurosurgical Society 2021-04 2021-03-04 /pmc/articles/PMC8048115/ /pubmed/33658457 http://dx.doi.org/10.2176/nmc.oa.2020-0308 Text en © 2021 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Article
YAMAGUCHI, Shigeru
MOTEGI, Hiroaki
ISHI, Yukitomo
OKAMOTO, Michinari
SAWAYA, Ryosuke
KOBAYASHI, Hiroyuki
TERASAKA, Shunsuke
HOUKIN, Kiyohiro
Clinical Outcome of Cytoreductive Surgery Prior to Bevacizumab for Patients with Recurrent Glioblastoma: A Single-center Retrospective Analysis
title Clinical Outcome of Cytoreductive Surgery Prior to Bevacizumab for Patients with Recurrent Glioblastoma: A Single-center Retrospective Analysis
title_full Clinical Outcome of Cytoreductive Surgery Prior to Bevacizumab for Patients with Recurrent Glioblastoma: A Single-center Retrospective Analysis
title_fullStr Clinical Outcome of Cytoreductive Surgery Prior to Bevacizumab for Patients with Recurrent Glioblastoma: A Single-center Retrospective Analysis
title_full_unstemmed Clinical Outcome of Cytoreductive Surgery Prior to Bevacizumab for Patients with Recurrent Glioblastoma: A Single-center Retrospective Analysis
title_short Clinical Outcome of Cytoreductive Surgery Prior to Bevacizumab for Patients with Recurrent Glioblastoma: A Single-center Retrospective Analysis
title_sort clinical outcome of cytoreductive surgery prior to bevacizumab for patients with recurrent glioblastoma: a single-center retrospective analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048115/
https://www.ncbi.nlm.nih.gov/pubmed/33658457
http://dx.doi.org/10.2176/nmc.oa.2020-0308
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