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

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.

Basic information

Original name

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

Authors

KALITA, Ondrej (203 Czech Republic), Tomáš KAZDA (203 Czech Republic, guarantor, belonging to the institution), Stefan REGULI (203 Czech Republic), Radim JANČÁLEK (203 Czech Republic, belonging to the institution), Pavel FADRUS (203 Czech Republic, belonging to the institution), Marek SLACHTA (203 Czech Republic), Petr POSPÍŠIL (203 Czech Republic, belonging to the institution), Lukas KRSKA (203 Czech Republic), Jana VRBKOVA (203 Czech Republic), Lumir HRABALEK (203 Czech Republic), Martin SMRČKA (203 Czech Republic, belonging to the institution) and Radim LIPINA (203 Czech Republic)

Edition

Cancers, BASEL, MDPI, 2023, 2072-6694

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 5.200 in 2022

RIV identification code

RIV/00216224:14110/23:00131197

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.3390/cancers15092530

UT WoS

000987086900001

Keywords in English

glioblastoma; reoperation timing; treatment strategy

Abstract

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.

Links

MUNI/A/1379/2022, interní kód MU

Name: Organotypické kultury glioblastomu – personalizované testování protinádorové léčby II

Investor: Masaryk University

Citovat

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. Cancers. BASEL: MDPI, 2023, vol. 15, No 9, p. 1-17. ISSN 2072-6694. Available from: https://dx.doi.org/10.3390/cancers15092530.

@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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