Optimal extent of resection for glioblastoma according to site, extension, and size: a population-based study in the temozolomide era
Optimal extent of resection for glioblastoma according to site, extension, and size: a population-based study in the temozolomide era
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DOI：
10.1007/s10143-018-01071-3
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发表时间：
2019-12-01
影响因子：
2.8
通讯作者：
Kim, In Ah
中科院分区：
文献类型：
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作者：
Kim, Yi-Jun;Lee, David J.;Kim, In Ah
切除范围（EOR）对胶质母细胞瘤预后的影响可能因各种情况而异。我们根据肿瘤的部位、范围和大小评估了EOR对胶质母细胞瘤预后的影响。从监测、流行病学和最终结果数据库中检索了2005年至2014年间接受大体全切除术（GTR）、次全切除术（STR）或开放性活检的胶质母细胞瘤患者的数据。对总生存期（OS）进行单变量和多变量分析。在2005-2009年和2010-2014年期间，实施的一般技术审查和可疑交易的比例分别从41.4%增加到42.3%和从33.0%增加到37.1%。EOR仅影响诊断后3年内的OS。GTR组（n=4155）、STR组（n=3498）和开放活检组（n=2258）的中位生存期分别为17、13和13个月（p= 6 cm），对于6-8 cm大小的肿瘤，GTR组的OS率显著高于STR组（p = 0.001）。对于>= 8 cm的肿瘤，STR与GTR相当（p= 0.61），上级于开放活检（p= 0.05）。当胶质母细胞瘤直径大于等于6 cm或已经越过中线以增加OS时，需要更频繁地进行GTR。当肿瘤大于等于8 cm时，STR略上级开放活检。
The effect of the extent of resection (EOR) on prognosis in glioblastoma may differ depending on various conditions. We evaluated the prognostic impact of the EOR for glioblastoma according to the tumor site, extension, and size. Data from glioblastoma patients who underwent gross total resection (GTR), subtotal resection (STR), or open biopsy between 2005 and 2014 were retrieved from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate analyses for overall survival (OS) were performed. Between 2005-2009 and 2010-2014, the proportion of GTR and STR performed increased from 41.4 to 42.3% and 33.0 to 37.1%, respectively. EOR only affected OS in the 3 years after diagnosis. Median survival in the GTR (n=4155), STR (n=3498), and open biopsy (n=2258) groups was 17, 13, and 13 months, respectively (p= 6 cm in size, GTR significantly increased the OS rate relative to STR for tumors 6-8 cm in size (p = .001). For tumors >= 8 cm, STR was comparable to GTR (p=.61) and superior to open biopsy (p=.05). GTR needs to be performed more frequently for glioblastoma measuring >= 6 cm or that have crossed the midline to increase OS. STR was marginally superior to open biopsy when the tumor was >= 8 cm.