Journal
ANNALS OF SURGICAL ONCOLOGY
Volume 25, Issue 2, Pages 558-564Publisher
SPRINGER
DOI: 10.1245/s10434-017-6253-0
Keywords
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Funding
- KKF TU Munich
- Biogen Idec
- Quintiles
- MSD Sharp Dome
- Boehringer Ingelheim
- Inventive Health Clinical UK Ltd.
- Advance Cor
- Brainsgate
- Pfizer
- Bayer-Schering
- Novartis
- Roche
- Servier
- Penumbra
- WCT GmbH
- Syngis
- SSS International Clinical Research
- PPD Germany GmbH
- Worldwide Clinical Trials Ltd.
- Phenox
- Covidien
- Actelion
- Medivation
- Medtronic
- Harrison Clinical Research
- Concentric
- Pharmtrace
- Reverse Medical Corp.
- Premier Research Germany Ltd.
- Surpass Medical Ltd.
- GlaxoSmithKline
- ERC grant
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Incomplete resection of glioblastoma is discussed controversially in the era of combined radiochemotherapy. The aim of this study was to analyze the benefit of subtotal tumor resection for glioblastoma patients as this was recently questioned in the era of radiochemotherapy. Overall, 209 patients undergoing surgery for newly diagnosed WHO grade IV gliomas were retrospectively analyzed, and pre- and postoperative tumor volumes were manually segmented (cm(3)). Survival analyses were performed, including prognostic factors such as age, Karnofsky performance score (KPS), O-6-methylguanine-DNA-methyltransferase (MGMT) promoter methylation status, and adjuvant treatment regimen. Pre- and postoperative tumor volume is significantly associated with pre- and postoperative KPS, as well as age (p < 0.001). Postoperative tumor volume remained a significant prognostic factor in a multivariate analysis, independent of other prognostic factors (hazard ratio 1.0365, 95% confidence interval 1.0235-1.0497, p < 0.001). In the era of molecularly-driven radiochemotherapy, glioblastoma surgery remains a major prognostic factor. Even in situations in which a gross total resection cannot be achieved, maximum safe reduction of tumor burden should be attempted.
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