Supratotal Resection: An Emerging Concept of Glioblastoma Multiforme Surgery-Systematic Review And Meta-Analysis

World Neurosurg. 2023 Nov:179:e46-e55. doi: 10.1016/j.wneu.2023.07.020. Epub 2023 Jul 13.

Abstract

Background: The severe neurologic tumor known as glioblastoma (GBM), also referred to as a grade IV astrocytoma, is rapidly progressive and debilitating. Supratotal resection (SpTR) is an emerging concept within glioma surgery, which aims to achieve a more extensive resection of the tumor than is possible with conventional techniques.

Methods: We performed a language-independent search of PubMed, Scopus, and Cochrane CENTRAL to identify all available literature up to August 2022 of patients undergoing SpTR assessing survival outcomes in comparison to other surgical modalities.

Results: After screening for exclusion, a total of 13 studies, all retrospective in design, were identified and included in our meta-analysis. SpTR was associated with significantly increased overall survival (hazard ratio 0.77, 95% CI 0.71-0.84; P < 0.01, I2 = 96%) and progression-free survival (hazard ratio 0.2, 95% CI 0.07-0.56; P = 0.002, I2 = 88%).

Conclusion: SpTR is associated with greater overall survival and PFS when compared with other glioblastoma surgeries like GTR or SubTR.

Keywords: Astrocytoma; Glioblastoma; Supra complete; Supramarginal resection; Supratotal resection.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Astrocytoma* / surgery
  • Brain Neoplasms* / surgery
  • Glioblastoma* / surgery
  • Glioma* / surgery
  • Humans
  • Neurosurgical Procedures / methods
  • Retrospective Studies