'Recurrent' glioblastoma multiforme, when should we reoperate?
The surgical management of recurrent glioblastoma multiforme is controversial. Recent publications suggest that re-operation provides 3-5 months median survival, without significant increases in morbidity or mortality. Age (< or =50 years, although older patients may also benefit) and performance status (Karnofsky performance score > or =60-70) are the most important factors. Re-resection not only improves symptoms and maintains quality of life, it can delay symptom progression, reduce corticosteroid doses, and also improve response to (and allow intra-operative) chemotherapy and/or radiotherapy. Surgical treatment of recurrent glioblastoma multiforme in selected patients should always be considered.
Barbagallo
Giuseppe M V
GM
Department of Neurosurgery, The Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerly, Liverpool, UK. giuseppebarbagal@hotmail.com
Jenkinson
Michael D
MD
Brodbelt
Andrew R
AR
D000367:Age Factors; D001932:Brain Neoplasms / Q000601:surgery*; D005909:Glioblastoma / Q000601:surgery*; D006801:Humans; D017567:Karnofsky Performance Status; D011379:Prognosis; D012008:Recurrence; D012086:Reoperation; D013997:Time Factors