The effect of re-operation on survival in patients with recurrent glioblastoma.
BACKGROUND
Treatment options for glioblastoma (GBM) at recurrence have limited efficacy. Re-surgery has been used for confirmation of recurrent disease and to provide relief of symptoms but the real impact on survival is unknown.


METHODS
A retrospective analysis was performed for GBM patients followed between 01/2005 and 06/2010 at our Institution.


RESULTS
Two hundred and thirty-two patients with recurrent GBM were evaluated. One hundred and two patients (44%) were treated with re-surgery followed by chemotherapy and 130 patients (56%) with chemotherapy alone. In multivariate analysis, no significant effect of re-surgery was found, with age (p=0.001), MGMT methylation (p=0.002) and PFS at 6 months (p=0.0001) being significant prognostic factors.


CONCLUSIONS
Second surgery might have a limited impact in the clinical course of recurrent GBM patients.
Department of Medical Oncology, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
Enrico
E
Franceschi
Department of Medical Oncology, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
Marco
M
Bartolotti
Department of Medical Oncology, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
Alicia
A
Tosoni
Department of Medical Oncology, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
Stefania
S
Bartolini
Department of Neurosurgery, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
Carmelo
C
Sturiale
Department of Neurosurgery, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
Antonio
A
Fioravanti
Department of Neurosurgery, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
Eugenio
E
Pozzati
Department of Health Sciences, University of L'Aquila, L'Aquila, Italy.
Renato
R
Galzio
Section of Neurosurgery, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, University Hospital, Verona, Italy.
Andrea
A
Talacchi
Department of Neuroscience and Neurosurgery, San Bortolo Hospital, Vicenza, Italy.
Lorenzo
L
Volpin
Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy.
Luca
L
Morandi
Pathology Department, San Bortolo Hospital, Vicenza, Italy.
Daniela
D
Danieli
Department of Neurosciences, Statistic and Informatic Unit, Azienda Ospedale-Università, Padova, Italy.
Mario
M
Ermani
Department of Medical Oncology, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy alba.brandes@yahoo.it.
Alba A
AA
Brandes
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000601:surgery*; D005909:Glioblastoma / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies
Glioblastoma; radiotherapy; second surgery; surgery; temozolomide