Aggressive Surgery Linked to Better Outcomes in Glioblastoma

Patients who underwent gross total resection had a significantly increased 1-year survival rate.

Increased resection in patients with glioblastoma is linked to increased survival and decreased disease progression, a recent study indicates.

Surgical intervention for patients with glioblastoma multiforme (GBM) can range from a biopsy or subtotal resection (STR), to a more aggressive craniotomy with the goal of gross total resection (GTR). Due to concerns about injury and the anatomy of the brain, GTR can become difficult in some cases, according to a study published in JAMA Oncology.

Researchers included 41,117 patients in the meta-analysis to compare overall survival and progression-free survival in both surgeries. They discovered that the relative risk of death decreased at 1 and 2 years for GTR compared with STR.

The researchers also found GTR had an increased 1-year survival rate of 61% compared with STR. The 2-year survival was also seen to increase approximately 19% compared with STR.

Mortality rate also decreased in STR compared with biopsy at 1 year. Both STR and GTR had decreased mortality rates compared with biopsy, according to the study. The overall rate of mortality decreased as the extent of the surgery increased.

"Although the available studies are retrospective and mostly carry a high risk for bias and confounding, an overwhelming consistency of the evidence (including three class 2 studies) supports the superiority of GTR over STR and biopsy. ... Therefore, when clinically feasible, the body of literature favors GTR in all patients with newly diagnosed GBM," the authors concluded.