Role of Resection in Glioblastoma Management

Mark W Youngblood; Roger Stupp; Adam M Sonabend

doi:10.1016/j.nec.2020.08.002

Role of Resection in Glioblastoma Management

Neurosurg Clin N Am. 2021 Jan;32(1):9-22. doi: 10.1016/j.nec.2020.08.002. Epub 2020 Nov 5.

Authors

Mark W Youngblood¹, Roger Stupp², Adam M Sonabend³

Affiliations

¹ Department of Neurological Surgery, Northwestern University, Northwestern Medicine, 676 North Saint Clair Street, Suite 2210, Chicago, IL 60611, USA.
² Department of Neurological Surgery, Northwestern University, Northwestern Medicine, 676 North Saint Clair Street, Suite 2210, Chicago, IL 60611, USA; Department of Neurology, Northwestern University, 676 North Saint Clair Street, Suite 2210, Chicago, IL 60611, USA; Department of Medicine, Division of Hematology and Oncology, Northwestern University, 676 North Saint Clair Street, Suite 2210, Chicago, IL 60611, USA; Lou and Jean Malnati Brain Tumor Institute, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 North Saint Clair Street, Suite 2210, Chicago, IL 60611, USA.
³ Department of Neurological Surgery, Northwestern University, Northwestern Medicine, 676 North Saint Clair Street, Suite 2210, Chicago, IL 60611, USA; Lou and Jean Malnati Brain Tumor Institute, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 North Saint Clair Street, Suite 2210, Chicago, IL 60611, USA. Electronic address: adam.sonabend@nm.org.

PMID: 33223030
DOI: 10.1016/j.nec.2020.08.002

Abstract

Whenever possible, maximal safe resection is the first intervention for management of glioblastoma. Resection offers tissue for diagnosis, decompression of the brain, cytoreduction, and has been associated with prolonged survival in numerous retrospective studies. In this review, we provide a critical overview of the literature associating glioblastoma resection with survival. We discuss techniques that enhance extent of resection, and the role of clinical and surgeon-variables. At last, we analyze the covariates and confounders that might influence the relationship between extent of resection and survival for glioblastoma, as these might ultimately also influence outcomes and other therapeutic interventions tested in trials.

Keywords: Cytoreduction; Glioblastoma resection; Operative adjuncts; Resectability; Supratotal resection; Survival.

Publication types

Review

MeSH terms

Brain Neoplasms / diagnosis
Brain Neoplasms / mortality
Brain Neoplasms / surgery*
Glioblastoma / diagnosis
Glioblastoma / mortality
Glioblastoma / surgery*
Humans
Neoplasm, Residual / surgery
Neurosurgical Procedures*
Survival Analysis