复发性胶质母细胞瘤二次手术后的患者预后。
Patient outcomes following second surgery for recurrent glioblastoma.
作者信息
Brandes Alba A, Bartolotti Marco, Tosoni Alicia, Poggi Rosalba, Bartolini Stefania, Paccapelo Alexandro, Bacci Antonella, Ghimenton Claudio, Pession Annalisa, Bortolotti Carlo, Zucchelli Mino, Galzio Renato, Talacchi Andrea, Volpin Lorenzo, Marucci Gianluca, de Biase Dario, Pizzolitto Stefano, Danieli Daniela, Ermani Mario, Franceschi Enrico
机构信息
Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
Department of Neuroradiology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
出版信息
Future Oncol. 2016;12(8):1039-44. doi: 10.2217/fon.16.9. Epub 2016 Feb 16.
BACKGROUND
The most appropriate management of recurrent glioblastoma is still controversial. In particular, the role of surgery at recurrence remains uncertain.
PATIENTS & METHODS: From our Institutional data warehouse we analyzed 270 consecutive patients who received second surgery for recurrent glioblastoma, to assess survival after second surgery, and to evaluate prognostic factors.
RESULTS
Complete resection was found in 128 (47.4%) and partial resection in 142 patients (52.6%). Median survival from second surgery was 11.4 months (95% CI: 10.0-12.7). Multivariate analysis showed that age (p = 0.001), MGMT methylation (p = 0.021) and extent of surgery (p < 0.001) are associated with better survival.
CONCLUSION
A complete resection should be the goal for second resection and younger age and MGMT methylation status might be considered in the selection of patients.
背景
复发性胶质母细胞瘤的最佳治疗方案仍存在争议。特别是，复发时手术的作用仍不明确。
患者与方法
我们从机构数据仓库中分析了270例连续接受复发性胶质母细胞瘤二次手术的患者，以评估二次手术后的生存率，并评估预后因素。
结果
128例（47.4%）实现了完全切除，142例（52.6%）为部分切除。二次手术后的中位生存期为11.4个月（95%置信区间：10.0 - 12.7）。多变量分析显示，年龄（p = 0.001）、MGMT甲基化（p = 0.021）和手术范围（p < 0.001）与更好的生存率相关。
结论
二次切除的目标应为完全切除，在选择患者时可考虑年龄较轻和MGMT甲基化状态。
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