Presence of Histopathological Treatment Effects at Resection of Recurrent Glioblastoma: Incidence and Effect on Outcome.
Bevacizumab
Glioblastoma
Radiation necrosis
Recurrent
Treatment effect
Journal
Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914
Informations de publication
Date de publication:
01 12 2019
01 12 2019
Historique:
received:
20
04
2018
accepted:
24
09
2018
pubmed:
18
11
2018
medline:
14
4
2020
entrez:
17
11
2018
Statut:
ppublish
Résumé
Resection may be appropriate for select patients with recurrent glioblastoma. The incidence of histopathological findings related to prior treatment and their prognostic implications are incompletely characterized. To quantify the incidence and survival outcomes associated with treatment effect at resection of recurrent glioblastoma (GBM). Patients who underwent resection for recurrent GBM were retrospectively reviewed, and pathology, treatment history, and survival data were collected. Treatment effect was defined as any component of treatment-related changes on pathology. In total, 110 patients underwent 146 reoperations. Median age at first reoperation was 57.2 yr and overall survival from reoperation was 10.8 mo. Treatment effect of any kind was noted in 81 of 146 reoperations (55%). Increased treatment effect was observed closer to radiotherapy; by quartile of time from radiotherapy, the rates of treatment effect were 77.8%, 55.6%, 40.7%, and 44.4% (P = .028). Treatment effect was associated with earlier reoperation (8.9 vs 13.8 mo after radiotherapy, P = .003), and the presence of treatment effect did not impact survival from primary surgery (25.4 vs 24.3 mo, P = .084). Patients treated with bevacizumab prior to reoperation were less likely to have treatment effect (20% vs 65%, P < .001). Histopathological treatment-related changes are evident in a majority of patients undergoing resection for recurrent glioblastoma. There was no association of treatment effect with overall survival from primary surgery.
Sections du résumé
BACKGROUND
Resection may be appropriate for select patients with recurrent glioblastoma. The incidence of histopathological findings related to prior treatment and their prognostic implications are incompletely characterized.
OBJECTIVE
To quantify the incidence and survival outcomes associated with treatment effect at resection of recurrent glioblastoma (GBM).
METHODS
Patients who underwent resection for recurrent GBM were retrospectively reviewed, and pathology, treatment history, and survival data were collected. Treatment effect was defined as any component of treatment-related changes on pathology.
RESULTS
In total, 110 patients underwent 146 reoperations. Median age at first reoperation was 57.2 yr and overall survival from reoperation was 10.8 mo. Treatment effect of any kind was noted in 81 of 146 reoperations (55%). Increased treatment effect was observed closer to radiotherapy; by quartile of time from radiotherapy, the rates of treatment effect were 77.8%, 55.6%, 40.7%, and 44.4% (P = .028). Treatment effect was associated with earlier reoperation (8.9 vs 13.8 mo after radiotherapy, P = .003), and the presence of treatment effect did not impact survival from primary surgery (25.4 vs 24.3 mo, P = .084). Patients treated with bevacizumab prior to reoperation were less likely to have treatment effect (20% vs 65%, P < .001).
CONCLUSION
Histopathological treatment-related changes are evident in a majority of patients undergoing resection for recurrent glioblastoma. There was no association of treatment effect with overall survival from primary surgery.
Identifiants
pubmed: 30445646
pii: 5184868
doi: 10.1093/neuros/nyy501
pmc: PMC7054709
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
793-800Subventions
Organisme : NINDS NIH HHS
ID : R01 NS079697
Pays : United States
Informations de copyright
Copyright © 2018 by the Congress of Neurological Surgeons.
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