title: The role of cytoreductive surgery in the management of progressive glioblastoma : a systematic review and evidence-based clinical practice guideline.
abstract: OBJECTIVE
  Should patients with previously diagnosed malignant glioma who are suspected of experiencing progression of the neoplasm process undergo repeat open surgical resection?
  
  
  METHODS
  These recommendations apply to adults with previously diagnosed malignant glioma who are suspected of experiencing progression of the neoplastic process and are amenable to surgical resection.
  Repeat cytoreductive surgery is recommended in symptomatic patients with locally recurrent or progressive malignant glioma. The median survival in these patient diagnosed with glioblastoma is expected to range from 6 to 17 months following a second procedure. It is recommended that the following preoperative factors be considered when evaluating a patient for repeat operation: location of recurrence in eloquent/critical brain regions, Karnofsky Performance Status and tumor volume.
authors.affiliation: Department of Neurosurgery, Iowa Spine and Brain Institute, Waterloo, IA, USA, timothy-ryken@uiowa.edu.
authors.forename: Timothy Charles
authors.initials: TC
authors.lastname: Ryken
authors.forename: Steven N
authors.initials: SN
authors.lastname: Kalkanis
authors.forename: John M
authors.initials: JM
authors.lastname: Buatti
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Olson
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D019317:Evidence-Based Medicine; D005909:Glioblastoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures / Q000379:methods*; D047368:Tumor Burden
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