Influence of second surgery on overall survival of recurrent glioblastoma
EANS Academy. Mracek J. 09/25/19; 275683; EP03014
Dr. Jan Mracek
Dr. Jan Mracek

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Background: Glioblastoma multiforme (GBM) is most malignant brain tumor with overall survival (OS) 14-17 months after surgery followed by complex radiochemotherapy. Gross total removal contibutes to better outcome. Influence of second surgery in GBM recurrency is disputable. Authors present their experience with redo surgery in GBM and compare OS and PFS with control group of recurrency without second surgery.
Methods: Twenty-two patients were operated for GBM recurrency in 2014-18 in our hospital (group I). Control group without surgery for recurrency consisted of 22 patients as well (group II). Evaluated parameters were age, gender, OS, progression free survival (PFS), clinical status 30d after surgery (GOSE), treatment complexity, tumor location, 5-ALA administration. Diagnostic proof of GBM recurrency and pseudoprogresion exclusion was performed by combination DWI MRI, DCE MRI, MRS and PET MR. Karnofsky score 70 or more was condition for surgery.
Results: Group I:Mean age was 59 years, OS 19.3 months, OS2 from second surgery to death 10 month, PFS 12.4 months,
Group II: Mean age was 66 years, OS 11,4 months, PFS 5 months. Resection radicality has been evaluated as gross total, subtotal and parcial (including biopsy). There was no statistical difference in resection radicality in both groups. Lower age was significant parameter for prolonged OS and PFS. Gender had no influence on OS and PFS.
Conclusions: There were better results (OS, PFS) in second surgery group for recurrent GBM. Lower age was significatly corellated with better outcome. Radicality of surgery positively influenced OS and PFS. Gender and 5-ALA did not influenced outcome.
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