Survival and Functional Status after Resection of Recurrent Glioblastoma Multiforme

摘要: Objective To determine the selection factors for and results of second resections performed to treat recurrent glioblastoma multiforme (GM), we studied 301 patients with GM who were treated from time diagnosis using two prospective clinical protocols. Methods The prospectively followed diagnosis, radiographic criteria after maximal surgical resection external beam radiotherapy or without adjuvant chemotherapy. Resection was at recommendation treating clinicians. retrospectively reviewed analyzed multivariate logistic regression, Kaplan-Meier-Turnbull survival analysis, Cox propensity score stratification. Results Forty-six underwent during study period. actuarial rate 15% 1 year 31% 2 years diagnosis. Younger age (P = 0.01) more extensive initial 0.02), but not Karnofsky Performance Scale (KPS) recurrence, predicted a higher chance reoperation tumor recurrence. Twenty-eight percent had improved KPS scores undergoing reoperation, 49% stable, 23% declines in 10 30 points. There no operative mortality. After 85% received chemotherapy, 11% brachytherapy stereotactic radiosurgery, 17% third resections. median period 36 weeks. Higher preoperative longer periods 0.03). Age interval since significant prognostic factors. high-quality (KPS score, > =70) 18 first progression 23 weeks 130 same protocols did undergo reoperations. Patients reoperations experienced clinically statistically significantly periods. However, this determined be partially because bias. Conclusion Survival remains poor despite advances imaging, technique, therapies. High-quality recurrence seems have increased an earlier report our institution.