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@article{2296978,
author = {Kalita, Ondrej and Kazda, Tomáš and Reguli, Stefan and Jančálek, Radim and Fadrus, Pavel and Slachta, Marek and Pospíšil, Petr and Krska, Lukas and Vrbkova, Jana and Hrabalek, Lumir and Smrčka, Martin and Lipina, Radim},
article_location = {BASEL},
article_number = {9},
doi = {http://dx.doi.org/10.3390/cancers15092530},
keywords = {glioblastoma; reoperation timing; treatment strategy},
language = {eng},
issn = {2072-6694},
journal = {Cancers},
title = {Effects of Reoperation Timing on Survival among Recurrent Glioblastoma Patients: A Retrospective Multicentric Descriptive Study},
url = {https://www.mdpi.com/2072-6694/15/9/2530},
volume = {15},
year = {2023}
}
TY - JOUR
ID - 2296978
AU - Kalita, Ondrej - Kazda, Tomáš - Reguli, Stefan - Jančálek, Radim - Fadrus, Pavel - Slachta, Marek - Pospíšil, Petr - Krska, Lukas - Vrbkova, Jana - Hrabalek, Lumir - Smrčka, Martin - Lipina, Radim
PY - 2023
TI - Effects of Reoperation Timing on Survival among Recurrent Glioblastoma Patients: A Retrospective Multicentric Descriptive Study
JF - Cancers
VL - 15
IS - 9
SP - 1-17
EP - 1-17
PB - MDPI
SN - 20726694
KW - glioblastoma
KW - reoperation timing
KW - treatment strategy
UR - https://www.mdpi.com/2072-6694/15/9/2530
N2 - 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.
ER -
KALITA, Ondrej, Tomáš KAZDA, Stefan REGULI, Radim JANČÁLEK, Pavel FADRUS, Marek SLACHTA, Petr POSPÍŠIL, Lukas KRSKA, Jana VRBKOVA, Lumir HRABALEK, Martin SMRČKA and Radim LIPINA. Effects of Reoperation Timing on Survival among Recurrent Glioblastoma Patients: A Retrospective Multicentric Descriptive Study. \textit{Cancers}. BASEL: MDPI, 2023, vol.~15, No~9, p.~1-17. ISSN~2072-6694. Available from: https://dx.doi.org/10.3390/cancers15092530.
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