Details

Autor(en) / Beteiligte

• Rapp, Marion
• Baernreuther, Jessica
• Turowski, Bernd
• Steiger, Hans-Jakob
• Sabel, Michael
• Kamp, Marcel A

Titel

Recurrence pattern analysis of primary glioblastoma

Ist Teil von

• World neurosurgery, 2017-07, Vol.103, p.733-740

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Objective The typical recurrence of a glioblastoma occurs locally, usually within 2 cm from the original lesion. With the improvement of surgery techniques, more aggressive surgical strategies have become feasible, resulting in a significantly increased rate of complete resection. Therefore, we were interested, if these improvements are also reflected by the tumor recurrence pattern. Patients and methods Inclusion criteria were: first diagnosis of glioblastoma, followed by standard adjuvant radio-chemotherapy and histologically proven tumor recurrence. Patients were divided according to the recurrence pattern: patients with a local vs. distant recurrence vs. both recurrence patterns. Data were correlated with extend of resection, molecular tumor configuration, clinical status and survival data. Results Between 2007 and 2014 we could include 97 GBM patients in this single center, retrospective study. Local, distant or combined tumor recurrence was observed in 77 (79.3%), 10 (10.3%) and 10 patients (10.3%), respectively. Median PFS of all patients was 8 months (m), median OS 20m. Median PFS for patients with local recurrence was 7m versus 13m for patients with distant recurrence vs. 9m for patients with both recurrences (p=0.646). Median OS was 21m vs. 20m (vs. 14m (p=0.098)), respectively. Regarding MGMT methylation status no correlation regarding recurrence pattern could be observed. Conclusions Despite complete resection of the contrast-enhancing tumor, the majority of recurrences occurred locally. Patients with distant tumor recurrence presented an increased PFS. Therefore, to gain a local control maybe we have to shift toward an even more aggressive “supramarginal” resection, using extensive intraoperative monitoring to avoid permanent deficits.