Author(s): Tanello T.; Foster M.; Farah J.; Jenkinson M.; Chavredakis E.; Brodbelt A.
Source: British Journal of Neurosurgery; 2018; vol. 32 (no. 1); p. 111
Publication Date: 2018
Publication Type(s): Conference Abstract
Abstract:Objectives: The role of repeat surgery after glioblastoma (GBM) recurrence is controversial. The purpose of the study was to evaluate overall survival following reoperation for GBM. Design: Retrospective single centre study. Subjects: All patients operated on a second time between Jan 2011 and Dec 2016 in a single centre following discussion in a neuroscience MDT Methods: Case note, imaging, operative note, and pathology report reviewed. Logistic regression used to assess one-year survival after second surgery against covariates. Results: 40 patients (26 Males) had a median age of 53.5 years (range 24-67). Median interval between the first and second operation was 78 weeks. 50% had a gross total resection (>90%) and 50% subtotal (50-90%). 5-ALA was used in 5 cases, Gliadel wafers were inserted in 15 patients (38%) and 2 followed a ketogenic diet. 22 (55%) had further radio and/or chemotherapy after reoperation. Seven (17.5%) patients were alive at the time of data collection. Of those deceased, median survival after reoperation was 45 weeks (60 weeks if PS 1). One-year survival after second surgery was 48.6%. Prior to second surgery, poor performance status (2 or more) was associated with worse chance of one-year survival following re-operation (OR 0.04, 95% CI 0.002 to 0.37, p=0.02). GTR, recurrence volume, age and surgeon were not significantly related to one-year survival (p > 0.5). Conclusions: Selective second surgery in good performance score patients with GBM can be associated with 14 months additional survival.