Second surgery for relapsed glioblastoma: an observational study on criteria for patient selection in real life.

There is little consensus on salvage management of glioblastoma after recurrence, for lack of evidence. A retrospective study of treatments in patients with recurrent glioblastoma. Surgery at recurrence was related to better overall survival (OS) and progression-free survival (PFS). Surgery at recurrence, Karnofsky index, methylation status, younger age at diagnosis and number of chemotherapy cycles were positive factors for OS and PFS. The benefit of OS was relevant for a second surgery performed at least 9 months after the first one. Systemic treatments after the second surgery were linked to an improved PFS. Younger age, Karnofsky index, methylation status and a median time between surgeries ≥9 months may be criteria for eligibility for surgery at recurrence.