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 |
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