The effect of re-operation on survival in patients with recurrent glioblastoma

Enrico Franceschi; Marco Bartolotti; Alicia Tosoni; Stefania Bartolini; Carmelo Sturiale; Antonio Fioravanti; Eugenio Pozzati; Renato Galzio; Andrea Talacchi; Lorenzo Volpin; Luca Morandi; Daniela Danieli; Mario Ermani; Alba A Brandes

The effect of re-operation on survival in patients with recurrent glioblastoma

Anticancer Res. 2015 Mar;35(3):1743-8.

Affiliations

¹ Department of Medical Oncology, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
² Department of Neurosurgery, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
³ Department of Health Sciences, University of L'Aquila, L'Aquila, Italy.
⁴ Section of Neurosurgery, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, University Hospital, Verona, Italy.
⁵ Department of Neuroscience and Neurosurgery, San Bortolo Hospital, Vicenza, Italy.
⁶ Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy.
⁷ Pathology Department, San Bortolo Hospital, Vicenza, Italy.
⁸ Department of Neurosciences, Statistic and Informatic Unit, Azienda Ospedale-Università, Padova, Italy.
⁹ Department of Medical Oncology, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy alba.brandes@yahoo.it.

PMID: 25750337

Abstract

Background: Treatment options for glioblastoma (GBM) at recurrence have limited efficacy. Re-surgery has been used for confirmation of recurrent disease and to provide relief of symptoms but the real impact on survival is unknown.

Patients and methods: A retrospective analysis was performed for GBM patients followed between 01/2005 and 06/2010 at our Institution.

Results: Two hundred and thirty-two patients with recurrent GBM were evaluated. One hundred and two patients (44%) were treated with re-surgery followed by chemotherapy and 130 patients (56%) with chemotherapy alone. In multivariate analysis, no significant effect of re-surgery was found, with age (p=0.001), MGMT methylation (p=0.002) and PFS at 6 months (p=0.0001) being significant prognostic factors.

Conclusion: Second surgery might have a limited impact in the clinical course of recurrent GBM patients.

Keywords: Glioblastoma; radiotherapy; second surgery; surgery; temozolomide.

MeSH terms

Adolescent
Adult
Aged
Brain Neoplasms / mortality
Brain Neoplasms / surgery*
Glioblastoma / mortality
Glioblastoma / surgery*
Humans
Middle Aged
Neoplasm Recurrence, Local / mortality
Neoplasm Recurrence, Local / surgery*
Reoperation
Retrospective Studies