Recurrent glioblastomas: Should we operate a second and even a third time?
Objectives: The aim of this study was i) to analyse the effect of repeat surgeries on the survival of patients with focally recurrent glioblastoma who have benefited from temozolomide treatment and ii) to identify potential prognostic factors for survival. Patients and methods: Cases from 2005 to 20...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-12-01
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| Series: | Interdisciplinary Neurosurgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751919300337 |
| _version_ | 1818516805043355648 |
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| author | Yahia-Cherif Djamel-Eddine, MD Olivier De Witte, MD, PhD Christian Mélot, MD, PhD, MSciBiostat Florence Lefranc, MD, PhD |
| author_facet | Yahia-Cherif Djamel-Eddine, MD Olivier De Witte, MD, PhD Christian Mélot, MD, PhD, MSciBiostat Florence Lefranc, MD, PhD |
| author_sort | Yahia-Cherif Djamel-Eddine, MD |
| collection | DOAJ |
| description | Objectives: The aim of this study was i) to analyse the effect of repeat surgeries on the survival of patients with focally recurrent glioblastoma who have benefited from temozolomide treatment and ii) to identify potential prognostic factors for survival. Patients and methods: Cases from 2005 to 2014 in the glioblastoma database of our department were retrospectively reviewed. The Kaplan-Meier method was used to estimate overall survival (OS) as a function of time after one, two and three surgical resections. All patients received the standard of care after the first surgery (temozolomide during and after radiotherapy) and adjuvant treatment after repeat surgeries. Results: One hundred-thirty-two glioblastoma patients (median age: 57 years) were included in the study. Among them, 68, 53 and 11 patients underwent one, two and three surgical resections, respectively. The median OS was 11, 16 and 18 months, respectively, for patients who underwent one, two and three surgical resections. Patients who underwent two (p < 0.001) or three (p < 0.01) surgeries survived significantly longer than patients who underwent only one. No significant difference was observed between patients who underwent two versus three surgeries (p = 0.76). A second resection performed >6 months after the initial resection was the only factor associated with prolonged survival (p = 0.008). Conclusion: Glioblastoma patients who benefited from temozolomide treatment and underwent surgery for recurrent glioblastoma exhibited a significant increase in survival compared with patients who did not undergo a second surgery. By contrast, a third surgery for a second recurrence did not contribute to any significant survival benefit. |
| first_indexed | 2024-12-11T00:47:24Z |
| format | Article |
| id | doaj.art-80850b7f7be444c88c94779b55ebbeaa |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-11T00:47:24Z |
| publishDate | 2019-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-80850b7f7be444c88c94779b55ebbeaa2022-12-22T01:26:43ZengElsevierInterdisciplinary Neurosurgery2214-75192019-12-0118Recurrent glioblastomas: Should we operate a second and even a third time?Yahia-Cherif Djamel-Eddine, MD0Olivier De Witte, MD, PhD1Christian Mélot, MD, PhD, MSciBiostat2Florence Lefranc, MD, PhD3Department of Neurosurgery, Hôpital Erasme, BelgiumDepartment of Neurosurgery, Hôpital Erasme, BelgiumUniversité Libre de Bruxelles (ULB), Brussels, BelgiumDepartment of Neurosurgery, Hôpital Erasme, Belgium; Corresponding author at: Service de Neurochirurgie – Hôpital Erasme- Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium.Objectives: The aim of this study was i) to analyse the effect of repeat surgeries on the survival of patients with focally recurrent glioblastoma who have benefited from temozolomide treatment and ii) to identify potential prognostic factors for survival. Patients and methods: Cases from 2005 to 2014 in the glioblastoma database of our department were retrospectively reviewed. The Kaplan-Meier method was used to estimate overall survival (OS) as a function of time after one, two and three surgical resections. All patients received the standard of care after the first surgery (temozolomide during and after radiotherapy) and adjuvant treatment after repeat surgeries. Results: One hundred-thirty-two glioblastoma patients (median age: 57 years) were included in the study. Among them, 68, 53 and 11 patients underwent one, two and three surgical resections, respectively. The median OS was 11, 16 and 18 months, respectively, for patients who underwent one, two and three surgical resections. Patients who underwent two (p < 0.001) or three (p < 0.01) surgeries survived significantly longer than patients who underwent only one. No significant difference was observed between patients who underwent two versus three surgeries (p = 0.76). A second resection performed >6 months after the initial resection was the only factor associated with prolonged survival (p = 0.008). Conclusion: Glioblastoma patients who benefited from temozolomide treatment and underwent surgery for recurrent glioblastoma exhibited a significant increase in survival compared with patients who did not undergo a second surgery. By contrast, a third surgery for a second recurrence did not contribute to any significant survival benefit.http://www.sciencedirect.com/science/article/pii/S2214751919300337 |
| spellingShingle | Yahia-Cherif Djamel-Eddine, MD Olivier De Witte, MD, PhD Christian Mélot, MD, PhD, MSciBiostat Florence Lefranc, MD, PhD Recurrent glioblastomas: Should we operate a second and even a third time? Interdisciplinary Neurosurgery |
| title | Recurrent glioblastomas: Should we operate a second and even a third time? |
| title_full | Recurrent glioblastomas: Should we operate a second and even a third time? |
| title_fullStr | Recurrent glioblastomas: Should we operate a second and even a third time? |
| title_full_unstemmed | Recurrent glioblastomas: Should we operate a second and even a third time? |
| title_short | Recurrent glioblastomas: Should we operate a second and even a third time? |
| title_sort | recurrent glioblastomas should we operate a second and even a third time |
| url | http://www.sciencedirect.com/science/article/pii/S2214751919300337 |
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