Aziz Peer Asad, Memon Salma Farrukh, Hussain Mubarak, Memon A Rauf, Abbas Kiran, Qazi Shurjeel Uddin, Memon Riaz A R, Qambrani Kanwal Ali, Taj Osama, Ghazanfar Shamas, Ellahi Aayat, Ahmed Moiz
Department of Neurosurgery, Liaquat University of Medical Health Sciences, Jamshoro, Pakistan.
Department of Neurosurgery, Liaquat University of Medical Health Sciences, Jamshoro, Pakistan.
World Neurosurg. 2023 Nov;179:e46-e55. doi: 10.1016/j.wneu.2023.07.020. Epub 2023 Jul 13.
BACKGROUND: The severe neurologic tumor known as glioblastoma (GBM), also referred to as a grade IV astrocytoma, is rapidly progressive and debilitating. Supratotal resection (SpTR) is an emerging concept within glioma surgery, which aims to achieve a more extensive resection of the tumor than is possible with conventional techniques. METHODS: We performed a language-independent search of PubMed, Scopus, and Cochrane CENTRAL to identify all available literature up to August 2022 of patients undergoing SpTR assessing survival outcomes in comparison to other surgical modalities. RESULTS: After screening for exclusion, a total of 13 studies, all retrospective in design, were identified and included in our meta-analysis. SpTR was associated with significantly increased overall survival (hazard ratio 0.77, 95% CI 0.71-0.84; P < 0.01, I = 96%) and progression-free survival (hazard ratio 0.2, 95% CI 0.07-0.56; P = 0.002, I = 88%). CONCLUSION: SpTR is associated with greater overall survival and PFS when compared with other glioblastoma surgeries like GTR or SubTR.
背景：胶质母细胞瘤（GBM），也称为IV级星形细胞瘤，是一种严重的神经肿瘤，进展迅速且使人衰弱。超全切除（SpTR）是胶质瘤手术中一个新兴的概念，其目的是实现比传统技术更广泛的肿瘤切除。 方法：我们对PubMed、Scopus和Cochrane CENTRAL进行了独立于语言的检索，以识别截至2022年8月所有关于接受SpTR的患者与其他手术方式相比的生存结果的可用文献。 结果：在筛选排除后，共确定了13项研究，均为回顾性设计，并纳入我们的荟萃分析。SpTR与总生存期显著延长相关（风险比0.77，95%可信区间0.71 - 0.84；P < 0.01，I² = 96%）以及无进展生存期延长相关（风险比0.2，95%可信区间0.07 - 0.56；P = 0.002，I² = 88%）。 结论：与其他胶质母细胞瘤手术如全切除（GTR）或次全切除（SubTR）相比，SpTR与更长的总生存期和无进展生存期相关。
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