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复发性胶质母细胞瘤切除的临床获益:一项多中心研究结果,该研究纳入了503例接受手术切除的复发性胶质母细胞瘤患者。

Clinical benefit from resection of recurrent glioblastomas: results of a multicenter study including 503 patients with recurrent glioblastomas undergoing surgical resection.

作者信息

Ringel Florian, Pape Haiko, Sabel Michael, Krex Dietmar, Bock Hans Christoph, Misch Martin, Weyerbrock Astrid, Westermaier Thomas, Senft Christian, Schucht Philippe, Meyer Bernhard, Simon Matthias

机构信息

Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany (F.R., H.P., B.M.); Department of Neurosurgery, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany (M.S.); Department of Neurosurgery, Universitätsklinikum Carl Gustav Carus, Dresden, Germany (D.K.); Department of Neurosurgery, Universitätsmedizin Göttingen, , Göttingen, Germany (H.C.B.); Department of Neurosurgery, Charité Universitätsmedizin, Berlin, Germany (M.M.); Department of Neurosurgery, Universitätsklinikum Freiburg, Freiburg, Germany (A.W.); Department of Neurosurgery, Universitätsklinikum Würzburg, Würzburg, Germany (T.W.); Department of Neurosurgery, Goethe Universität Frankfurt, Frankfurt, Germany (C.S.); Department of Neurosurgery, Inselspital, Universitätsklinikum Bern, Bern, Switzerland (P.S.); Department of Neurosurgery, Universitätskliniken Bonn, Rheinische Friedrich Wilhelms Universität, Bonn, Germany (M.S.).

出版信息

Neuro Oncol. 2016 Jan;18(1):96-104. doi: 10.1093/neuonc/nov145. Epub 2015 Aug 4.

Abstract

BACKGROUND

While standards for the treatment of newly diagnosed glioblastomas exist, therapeutic regimens for tumor recurrence remain mostly individualized. The role of a surgical resection of recurrent glioblastomas remains largely unclear at present. This study aimed to assess the effect of repeated resection of recurrent glioblastomas on patient survival.

METHODS

In a multicenter retrospective-design study, patients with primary glioblastomas undergoing repeat resections for recurrent tumors were evaluated for factors affecting survival. Age, Karnofsky performance status (KPS), extent of resection (EOR), tumor location, and complications were assessed.

RESULTS

Five hundred and three patients (initially diagnosed between 2006 and 2010) undergoing resections for recurrent glioblastoma at 20 institutions were included in the study. The patients' median overall survival after initial diagnosis was 25.0 months and 11.9 months after first re-resection. The following parameters were found to influence survival significantly after first re-resection: preoperative and postoperative KPS, EOR of first re-resection, and chemotherapy after first re-resection. The rate of permanent new deficits after first re-resection was 8%.

CONCLUSION

The present study supports the view that surgical resections of recurrent glioblastomas may help to prolong patient survival at an acceptable complication rate.

摘要

背景

虽然新诊断的胶质母细胞瘤的治疗标准已经存在,但肿瘤复发的治疗方案大多仍是个体化的。目前,复发性胶质母细胞瘤手术切除的作用在很大程度上仍不明确。本研究旨在评估复发性胶质母细胞瘤重复切除对患者生存的影响。

方法

在一项多中心回顾性设计研究中,对因复发性肿瘤接受重复切除的原发性胶质母细胞瘤患者的生存影响因素进行了评估。评估了年龄、卡氏功能状态(KPS)、切除范围(EOR)、肿瘤位置和并发症。

结果

该研究纳入了在20家机构接受复发性胶质母细胞瘤切除的503例患者(最初诊断时间为2006年至2010年)。患者初次诊断后的中位总生存期为25.0个月,首次再次切除后的中位总生存期为11.9个月。发现以下参数在首次再次切除后对生存有显著影响:术前和术后KPS、首次再次切除的EOR以及首次再次切除后的化疗。首次再次切除后永久性新神经功能缺损的发生率为8%。

结论

本研究支持这样一种观点,即复发性胶质母细胞瘤的手术切除可能有助于在可接受的并发症发生率下延长患者生存期。

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Repeat-surgery at Glioblastoma recurrence, when and why to operate?胶质母细胞瘤复发时的再次手术:何时以及为何进行手术?
Clin Neurol Neurosurg. 2015 Sep;136:89-94. doi: 10.1016/j.clineuro.2015.05.024. Epub 2015 May 28.

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Benefit of tumor resection for recurrent glioblastoma.复发性胶质母细胞瘤肿瘤切除的益处。
J Neurooncol. 2014 Apr;117(2):365-72. doi: 10.1007/s11060-014-1397-2. Epub 2014 Feb 15.
2
Surgical outcomes in recurrent glioma: clinical article.复发性神经胶质瘤的手术治疗效果:临床文章
J Neurosurg. 2013 Jun;118(6):1224-31. doi: 10.3171/2013.2.JNS121731. Epub 2013 Mar 15.

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