title: Should we reoperate for recurrent high-grade astrocytoma?
abstract: Despite optimal treatment of post-operative radiotherapy and chemotherapy for newly diagnosed high-grade astrocytoma, nearly all patients eventually recur. However, the efficacy of reoperation for recurrent astrocytoma is still debatable as to different surgical indications. To investigate the therapeutic effect of reoperation on patients with recurrent high-grade astrocytoma more objectively, a retrospective case-matched study was carried out. The clinical data of 63 cases of recurrent high-grade astrocytoma treated between January 2006 and December 2008 were studied. A total of 21 cases received reoperation immediately after tumor recurrence, while 42 cases without reoperation were matched by gender, age, Karnofsky Performance Scale (KPS) score, histopathology, recurrent interval after the first operation, extent of initial surgery, adjuvant treatment and characteristics of recurrent tumor. The study showed that the median survival time was 7 months in the reoperation group, while in non-reoperation group, it was 4 months. There was significant difference on univariate analysis (P < 0.001). Moreover, the median duration time of progression-free survival (PFS) after tumor recurrence was significantly (P < 0.001) longer in the reoperation group (5 months) than that in the non-reoperation group (2.5 months). The prognostic factors of recurrent high-grade astrocytoma included reoperation, KPS score and tumor location. It was indicated that reoperation could prolong the survival time and improve the quality of survival in patients of recurrent high-grade astrocytoma.
authors: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou City, 310009, People's Republic of China.
authors: Jin-fang
authors: JF
authors: Xu
authors: Jun
authors: J
authors: Fang
authors: Yi
authors: Y
authors: Shen
authors: Jian-min
authors: JM
authors: Zhang
authors: Wei-guo
authors: WG
authors: Liu
authors: Hong
authors: H
authors: Shen
references: Int J Radiat Oncol Biol Phys. 1999 Jan 1;43(1):79-88
references: 9989517
references: Cancer. 2005 Nov 15;104(10):2168-73
references: 16220556
references: Clin Neurol Neurosurg. 1997 May;99(2):117-23
references: 9213056
references: Cancer. 1981 Feb 15;47(4):649-52
references: 6164465
references: Neurosurgery. 1998 Apr;42(4):709-20; discussion 720-3
references: 9574634
references: J Neurosurg. 1978 Sep;49(3):333-43
references: 355604
references: N Engl J Med. 2005 Mar 10;352(10):987-96
references: 15758009
references: Zentralbl Neurochir. 2001;62(2):43-7
references: 11786935
references: Am J Clin Oncol. 2004 Apr;27(2):195-204
references: 15057161
references: J Clin Oncol. 1999 Aug;17(8):2572-8
references: 10561324
references: Int J Radiat Oncol Biol Phys. 1994 Jul 1;29(4):719-27
references: 8040017
references: Neurosurgery. 2005 Oct;57(4):684-92; discussion 684-92
references: 16239880
references: J Neurooncol. 2007 Dec;85(3):339-43
references: 17579810
references: J Neurosurg. 2004 Jan;100(1):41-6
references: 14743910
references: Int J Radiat Oncol Biol Phys. 1989 Jun;16(6):1405-9
references: 2542195
references: Curr Opin Neurol. 2005 Dec;18(6):632-8
references: 16280673
references: J Clin Oncol. 1990 Jul;8(7):1277-80
references: 2358840
references: J Clin Oncol. 2010 Aug 20;28(24):3838-43
references: 20644085
references: Int J Radiat Oncol Biol Phys. 1996 Sep 1;36(2):433-41
references: 8892469
references: N Engl J Med. 2005 Mar 10;352(10):1036-8
references: 15758016
references: J Neurosurg. 2001 Aug;95(2):190-8
references: 11780887
references: J Clin Oncol. 2005 Dec 1;23(34):8863-9
references: 16314646
references: J Neurosurg. 1988 Oct;69(4):506-9
references: 3418382
references: Curr Opin Neurol. 2009 Dec;22(6):657-64
references: 19770658
references: Cancer. 1983 Apr 1;51(7):1209-20
references: 6825044
references: Neurology. 1989 Mar;39(3):430-2
references: 2538776
references: J Neurooncol. 2008 May;88(1):105-13
references: 18283418
references: Lancet Oncol. 2005 Dec;6(12):937-44
references: 16321761
references: Isr Med Assoc J. 2001 Apr;3(4):254-7
references: 11344836
references: Oncol Rep. 2000 Jul-Aug;7(4):899-904
references: 10854567
references: J Neurosurg. 1981 Dec;55(6):917-21
references: 6271933
references: J Cancer Res Clin Oncol. 2003 Aug;129(8):477-84
references: 12884028
references: Anticancer Res. 1998 Mar-Apr;18(2B):1303-11
references: 9615807
references: Strahlenther Onkol. 2005 Jun;181(6):372-7
references: 15925979
references: N Engl J Med. 2008 Jul 31;359(5):492-507
references: 18669428
references: J Clin Oncol. 2006 Mar 10;24(8):1273-80
references: 16525182
references: J Clin Oncol. 1999 Sep;17(9):2762-71
references: 10561351
references: Neurosurgery. 1987 Nov;21(5):615-21
references: 2827052
references: Lancet. 1995 Apr 22;345(8956):1008-12
references: 7723496
references: Br J Cancer. 2000 Sep;83(5):588-93
references: 10944597