title: Patient outcomes following second surgery for recurrent glioblastoma.
abstract: BACKGROUND
  The most appropriate management of recurrent glioblastoma is still controversial. In particular, the role of surgery at recurrence remains uncertain.
  
  
  METHODS
  From our Institutional data warehouse we analyzed 270 consecutive patients who received second surgery for recurrent glioblastoma, to assess survival after second surgery, and to evaluate prognostic factors.
  
  
  RESULTS
  Complete resection was found in 128 (47.4%) and partial resection in 142 patients (52.6%). Median survival from second surgery was 11.4 months (95% CI: 10.0-12.7). Multivariate analysis showed that age (p = 0.001), MGMT methylation (p = 0.021) and extent of surgery (p < 0.001) are associated with better survival.
  
  
  CONCLUSIONS
  A complete resection should be the goal for second resection and younger age and MGMT methylation status might be considered in the selection of patients.
authors.affiliation: Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Alba A
authors.initials: AA
authors.lastname: Brandes
authors.affiliation: Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bartolotti
authors.affiliation: Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Alicia
authors.initials: A
authors.lastname: Tosoni
authors.affiliation: Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Rosalba
authors.initials: R
authors.lastname: Poggi
authors.affiliation: Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Bartolini
authors.affiliation: Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Alexandro
authors.initials: A
authors.lastname: Paccapelo
authors.affiliation: Department of Neuroradiology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Bacci
authors.affiliation: Department of Pathology, Verona Hospital, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ghimenton
authors.affiliation: Department of Biomedical & NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pession
authors.affiliation: Department of Neurosurgery, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Bortolotti
authors.affiliation: Department of Neurosurgery, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Mino
authors.initials: M
authors.lastname: Zucchelli
authors.affiliation: Department of Health Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Galzio
authors.affiliation: Section of Neurosurgery, Department of Neurological, Neuropsychological, Morphological & Movement Sciences, University of Verona, University Hospital, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Talacchi
authors.affiliation: Department of Neuroscience & Neurosurgery, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Volpin
authors.affiliation: Department of Biomedical & NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Marucci
authors.affiliation: Department of Biomedical & NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: de Biase
authors.affiliation: Department of Pathology, Santa Maria della Misericordia Hospital, Udine, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pizzolitto
authors.affiliation: Department of Pathology, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Danieli
authors.affiliation: Department of Neurosciences, Statistic & Informatic Unit, Azienda Ospedale-Università, Padova, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Ermani
authors.affiliation: Department of Medical Oncology, Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Franceschi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D003131:Combined Modality Therapy; D019175:DNA Methylation; D015254:DNA Modification Methylases / Q000235:genetics; D045643:DNA Repair Enzymes / Q000235:genetics; D019468:Disease Management; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D019233:Retreatment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D025521:Tumor Suppressor Proteins / Q000235:genetics; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D025521:Tumor Suppressor Proteins; D015254:DNA Modification Methylases; C515491:MGMT protein, human; D045643:DNA Repair Enzymes
keywords: MGMT; age; glioblastoma; second surgery