Supratotal Resection of Glioblastoma: Better Survival Outcome than Gross Total Resection
Objective: Supratotal resection (SupTR) of glioblastoma allows for a superior long-term disease control and increases overall survival. On the other hand, aggressive conventional approaches, including gross total resections (GTR), are limited by the impairment risk of adjacent eloquent areas, which...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-02-01
|
| Series: | Journal of Personalized Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4426/13/3/383 |
| _version_ | 1797610789403623424 |
|---|---|
| author | Seung Hyun Baik So Yeon Kim Young Cheol Na Jin Mo Cho |
| author_facet | Seung Hyun Baik So Yeon Kim Young Cheol Na Jin Mo Cho |
| author_sort | Seung Hyun Baik |
| collection | DOAJ |
| description | Objective: Supratotal resection (SupTR) of glioblastoma allows for a superior long-term disease control and increases overall survival. On the other hand, aggressive conventional approaches, including gross total resections (GTR), are limited by the impairment risk of adjacent eloquent areas, which may cause severe postoperative functional morbidity. This study aimed to analyze institutional cases with respect to the potential survival benefits of additional resection, including lobectomy, as a paradigm for SupTR in patients of glioblastoma. Methods: Between 2014 and 2018, 15 patients with glioblastoma underwent SupTR (GTR and additional lobectomy) at the authors’ institution. The postoperative Karnofsky performance score (KPS), progression-free survival (PFS), and overall survival (OS) were analyzed for the patients. Results: Patients with SupTR showed significantly prolonged PFS and OS. The median PFS and OS values for the entire study group were 33.5 months (95% confidence intervals (CI): 18.5–57.3 months) and 49.1 months (95% CI: 24.7–86.6 months), respectively. Multivariate analysis revealed that the O6-DNA-methylguanine methyltransferase (MGMT) promoter methylation status was the only predictor for both superior PFS (<i>p</i> = 0.03, OR 5.7, 95% CI 1.0–49.8) and OS (<i>p</i> = 0.04, OR 6.5, 95% CI 1.1–40.2). There was no significant difference between the pre- and postoperative KPS scores. Conclusions: Our results suggest that SupTR with lobectomy allows for a superior PFS and OS without negatively affecting patient performance. However, due to the small number of patients, further studies that include more patients are needed. |
| first_indexed | 2024-03-11T06:19:58Z |
| format | Article |
| id | doaj.art-3ce10f1f2248414491c82fc21fdd246c |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-11T06:19:58Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-3ce10f1f2248414491c82fc21fdd246c2023-11-17T12:01:33ZengMDPI AGJournal of Personalized Medicine2075-44262023-02-0113338310.3390/jpm13030383Supratotal Resection of Glioblastoma: Better Survival Outcome than Gross Total ResectionSeung Hyun Baik0So Yeon Kim1Young Cheol Na2Jin Mo Cho3Department of Neurosurgery, International St Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Republic of KoreaDepartment of Neurosurgery, International St Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Republic of KoreaDepartment of Neurosurgery, International St Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Republic of KoreaDepartment of Neurosurgery, International St Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Republic of KoreaObjective: Supratotal resection (SupTR) of glioblastoma allows for a superior long-term disease control and increases overall survival. On the other hand, aggressive conventional approaches, including gross total resections (GTR), are limited by the impairment risk of adjacent eloquent areas, which may cause severe postoperative functional morbidity. This study aimed to analyze institutional cases with respect to the potential survival benefits of additional resection, including lobectomy, as a paradigm for SupTR in patients of glioblastoma. Methods: Between 2014 and 2018, 15 patients with glioblastoma underwent SupTR (GTR and additional lobectomy) at the authors’ institution. The postoperative Karnofsky performance score (KPS), progression-free survival (PFS), and overall survival (OS) were analyzed for the patients. Results: Patients with SupTR showed significantly prolonged PFS and OS. The median PFS and OS values for the entire study group were 33.5 months (95% confidence intervals (CI): 18.5–57.3 months) and 49.1 months (95% CI: 24.7–86.6 months), respectively. Multivariate analysis revealed that the O6-DNA-methylguanine methyltransferase (MGMT) promoter methylation status was the only predictor for both superior PFS (<i>p</i> = 0.03, OR 5.7, 95% CI 1.0–49.8) and OS (<i>p</i> = 0.04, OR 6.5, 95% CI 1.1–40.2). There was no significant difference between the pre- and postoperative KPS scores. Conclusions: Our results suggest that SupTR with lobectomy allows for a superior PFS and OS without negatively affecting patient performance. However, due to the small number of patients, further studies that include more patients are needed.https://www.mdpi.com/2075-4426/13/3/383glioblastomalobectomygross total resectionoverall survivalsupratotal resection |
| spellingShingle | Seung Hyun Baik So Yeon Kim Young Cheol Na Jin Mo Cho Supratotal Resection of Glioblastoma: Better Survival Outcome than Gross Total Resection Journal of Personalized Medicine glioblastoma lobectomy gross total resection overall survival supratotal resection |
| title | Supratotal Resection of Glioblastoma: Better Survival Outcome than Gross Total Resection |
| title_full | Supratotal Resection of Glioblastoma: Better Survival Outcome than Gross Total Resection |
| title_fullStr | Supratotal Resection of Glioblastoma: Better Survival Outcome than Gross Total Resection |
| title_full_unstemmed | Supratotal Resection of Glioblastoma: Better Survival Outcome than Gross Total Resection |
| title_short | Supratotal Resection of Glioblastoma: Better Survival Outcome than Gross Total Resection |
| title_sort | supratotal resection of glioblastoma better survival outcome than gross total resection |
| topic | glioblastoma lobectomy gross total resection overall survival supratotal resection |
| url | https://www.mdpi.com/2075-4426/13/3/383 |
| work_keys_str_mv | AT seunghyunbaik supratotalresectionofglioblastomabettersurvivaloutcomethangrosstotalresection AT soyeonkim supratotalresectionofglioblastomabettersurvivaloutcomethangrosstotalresection AT youngcheolna supratotalresectionofglioblastomabettersurvivaloutcomethangrosstotalresection AT jinmocho supratotalresectionofglioblastomabettersurvivaloutcomethangrosstotalresection |