Abstract：
The role of surgery in recurrent glioblastoma multiforme (GBM) remains a controversial topic. The goal of this study was to perform a case control analysis including time to tumor recurrence as an additional prognostic factor in order to determine which patients benefit most from repeat surgery.
Our brain tumor database was reviewed over a 10-year period for all adult (≥18 years old) patients with primary isocitrate dehydrogenase wildtype GBM who received surgery for recurrent disease. These patients were then age, sex, and treatment matched to case controls from our institution who received medical therapy for recurrent disease.
A total of 174 adult patients with GBM were included in the study, 87 patients who received surgery for recurrent GBM (surgery cohort) and 87 patients who did not receive surgery for recurrent GBM (nonsurgery cohort). The surgery cohort had longer overall survival (P = 0.0003) and postrecurrence survival (P = 0.001) than the nonsurgery cohort. When the surgery cohort was split into 2 groups on the basis of time to tumor recurrence, the long time to recurrence group (>6 months) demonstrated significantly increased survival compared with the short time to recurrence group (P < 0.0001). Multivariate analysis of both cohorts demonstrated surgery for recurrent GBM was independently significant after adjusting for age, Karnofsky Performance Scale, and time to tumor recurrence (P < 0.0001).
Surgery for recurrent GBM leads to improved survival independent of age, Karnofsky Performance Scale, and time to tumor recurrence. Patients with time to tumor recurrence >6 months benefit most from additional surgery.
Our brain tumor database was reviewed over a 10-year period for all adult (≥18 years old) patients with primary isocitrate dehydrogenase wildtype GBM who received surgery for recurrent disease. These patients were then age, sex, and treatment matched to case controls from our institution who received medical therapy for recurrent disease.
A total of 174 adult patients with GBM were included in the study, 87 patients who received surgery for recurrent GBM (surgery cohort) and 87 patients who did not receive surgery for recurrent GBM (nonsurgery cohort). The surgery cohort had longer overall survival (P = 0.0003) and postrecurrence survival (P = 0.001) than the nonsurgery cohort. When the surgery cohort was split into 2 groups on the basis of time to tumor recurrence, the long time to recurrence group (>6 months) demonstrated significantly increased survival compared with the short time to recurrence group (P < 0.0001). Multivariate analysis of both cohorts demonstrated surgery for recurrent GBM was independently significant after adjusting for age, Karnofsky Performance Scale, and time to tumor recurrence (P < 0.0001).
Surgery for recurrent GBM leads to improved survival independent of age, Karnofsky Performance Scale, and time to tumor recurrence. Patients with time to tumor recurrence >6 months benefit most from additional surgery.
摘要：
手术在复发性多形性胶质母细胞瘤（GBM）中的作用仍然是一个有争议的话题。这项研究的目的是进行病例对照分析，包括肿瘤复发时间作为额外的预后因素，以确定哪些患者从重复手术中受益最大。
我们的脑肿瘤数据库在10年内对所有接受复发性疾病手术的原发性异柠檬酸脱氢酶野生型GBM成人（≥18岁）患者进行了回顾。这些患者当时年龄较大，性别,与我们机构接受复发性疾病药物治疗的病例对照相匹配的治疗。
总共174名GBM成年患者被纳入研究，87例接受复发性GBM手术的患者（手术队列）和87例未接受复发性GBM手术的患者（非手术队列）。与非手术组相比，手术组的总生存期（P=0.0003）和复发后生存期（P=0.001）更长。当手术队列根据肿瘤复发时间分为两组时，与短期复发组相比，长期复发组（>6个月）的生存率显着提高（P<0.0001）。两个队列的多变量分析显示，在调整年龄后，复发性GBM的手术是独立显著的，Karnofsky性能量表，肿瘤复发时间(P<0.0001)。
复发性GBM的手术可以提高生存率，而与年龄无关。Karnofsky性能量表，和肿瘤复发的时间。肿瘤复发时间>6个月的患者从额外手术中获益最大。
我们的脑肿瘤数据库在10年内对所有接受复发性疾病手术的原发性异柠檬酸脱氢酶野生型GBM成人（≥18岁）患者进行了回顾。这些患者当时年龄较大，性别,与我们机构接受复发性疾病药物治疗的病例对照相匹配的治疗。
总共174名GBM成年患者被纳入研究，87例接受复发性GBM手术的患者（手术队列）和87例未接受复发性GBM手术的患者（非手术队列）。与非手术组相比，手术组的总生存期（P=0.0003）和复发后生存期（P=0.001）更长。当手术队列根据肿瘤复发时间分为两组时，与短期复发组相比，长期复发组（>6个月）的生存率显着提高（P<0.0001）。两个队列的多变量分析显示，在调整年龄后，复发性GBM的手术是独立显著的，Karnofsky性能量表，肿瘤复发时间(P<0.0001)。
复发性GBM的手术可以提高生存率，而与年龄无关。Karnofsky性能量表，和肿瘤复发的时间。肿瘤复发时间>6个月的患者从额外手术中获益最大。
