J 2023

Effects of Reoperation Timing on Survival among Recurrent Glioblastoma Patients: A Retrospective Multicentric Descriptive Study

KALITA, Ondrej, Tomáš KAZDA, Stefan REGULI, Radim JANČÁLEK, Pavel FADRUS et. al.

Základní údaje

Originální název

Effects of Reoperation Timing on Survival among Recurrent Glioblastoma Patients: A Retrospective Multicentric Descriptive Study

Autoři

KALITA, Ondrej (203 Česká republika), Tomáš KAZDA (203 Česká republika, garant, domácí), Stefan REGULI (203 Česká republika), Radim JANČÁLEK (203 Česká republika, domácí), Pavel FADRUS (203 Česká republika, domácí), Marek SLACHTA (203 Česká republika), Petr POSPÍŠIL (203 Česká republika, domácí), Lukas KRSKA (203 Česká republika), Jana VRBKOVA (203 Česká republika), Lumir HRABALEK (203 Česká republika), Martin SMRČKA (203 Česká republika, domácí) a Radim LIPINA (203 Česká republika)

Vydání

Cancers, BASEL, MDPI, 2023, 2072-6694

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Švýcarsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 5.200 v roce 2022

Kód RIV

RIV/00216224:14110/23:00131197

Organizační jednotka

Lékařská fakulta

UT WoS

000987086900001

Klíčová slova anglicky

glioblastoma; reoperation timing; treatment strategy

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 14. 2. 2024 09:11, Mgr. Tereza Miškechová

Anotace

V originále

Glioblastoma inevitably recurs, but no standard regimen has been established for treating this recurrent disease. Several reports claim that reoperative surgery can improve survival, but the effects of reoperation timing on survival have rarely been investigated. We, therefore, evaluated the relationship between reoperation timing and survival in recurrent GBM. A consecutive cohort of unselected patients (real-world data) from three neuro-oncology cancer centers was analyzed (a total of 109 patients). All patients underwent initial maximal safe resection followed by treatment according to the Stupp protocol. Those meeting the following criteria during progression were indicated for reoperation and were further analyzed in this study: (1) The tumor volume increased by >20-30% or a tumor was rediscovered after radiological disappearance; (2) The patient's clinical status was satisfactory (KS = 70% and PS WHO = gr. 2); (3) The tumor was localized without multifocality; (4) The minimum expected tumor volume reduction was above 80%. A univariate Cox regression analysis of postsurgical survival (PSS) revealed a statistically significant effect of reoperation on PSS from a threshold of 16 months after the first surgery. Cox regression models that stratified the Karnofsky score with age adjustment confirmed a statistically significant improvement in PSS for time-to-progression (TTP) thresholds of 22 and 24 months. The patient groups exhibiting the first recurrence at 22 and 24 months had better survival rates than those exhibiting earlier recurrences. For the 22-month group, the HR was 0.5 with a 95% CI of (0.27, 0.96) and a p-value of 0.036. For the 24-month group, the HR was 0.5 with a 95% CI of (0.25, 0.96) and a p-value of 0.039. Patients with the longest survival were also the best candidates for repeated surgery. Later recurrence of glioblastoma was associated with higher survival rates after reoperation.

Návaznosti

MUNI/A/1379/2022, interní kód MU
Název: Organotypické kultury glioblastomu – personalizované testování protinádorové léčby II
Investor: Masarykova univerzita, Organotypické kultury glioblastomu – personalizované testování protinádorové léčby II