Microsurgery for glioblastoma preserves short-term quality of life both in functionally impaired and independent patients.
OBJECTIVE
Considering the short remaining life expectancy with glioblastoma multiforme, numerous patients and their referring physicians are hesitant to use aggressive surgical treatment for fear of greater risk of neurological deterioration. The aim of our study was to determine whether surgical treatment of glioblastoma, utilizing modern microsurgical dissection techniques and tools, interferes with short-term quality of life.


METHODS
The functional status before and after 67 microsurgical operations in 65 patients with glioblastomas was studied retrospectively. To evaluate the patients' quality of life, their functional neurological status was correlated with the Karnofsky performance scale (KPS). Post-operative evaluation was done within 7 days of surgery.


RESULTS
No significant difference was found between the preoperative and the early postoperative functional status. Neither patient age nor the preoperative functional status determined a significant risk for postoperative functional deterioration. Patients with tumors involving so-called eloquent brain areas statistically worsened (p = 0.018); however, they showed only mild clinical impairment that was represented by a mean KPS status decline of less than -10. After total tumor resection, patients showed functional improvement.


CONCLUSIONS
Microsurgery is safe and effective in order to improve or preserve short-term quality of life in glioblastoma patients. Total tumor resection is not associated with a significantly greater risk for neurological deterioration, either in patients with preoperative functional impairment, or in functionally independent patients.
Mühlbauer
Manfred
M
Department of Neurosurgery, Donauspital SMZ-Ost, Vienna, Austria. ma.muhlbauer@netway.at
Gebhart
Evelyn
E
Pfisterer
Wolfgang
W
Knosp
Engelbert
E
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality / Q000601:surgery*; D001933:Brain Stem / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005625:Frontal Lobe / Q000601:surgery; D005909:Glioblastoma / Q000401:mortality / Q000601:surgery*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008526:Medulla Oblongata / Q000601:surgery; D008866:Microsurgery; D009778:Occipital Lobe / Q000601:surgery; D010296:Parietal Lobe / Q000601:surgery; D011788:Quality of Life; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000601:surgery; D013997:Time Factors