title: Performance of adjuvant treatment correlates with survival in reoperated glioblastomas.
abstract: OBJECTIVE
  To analyze cases of recurrent glioblastoma subjected to reoperation at a Brazilian public healthcare service.
  
  
  METHODS
  A total of 39 patients subjected to reoperation for recurrent glioblastoma at the Department of Neurosurgery, São Paulo Hospital, Federal University of São Paulo, from January 2000 to December 2013 were retrospectively analyzed.
  
  
  RESULTS
  The median overall survival was 20 months (95% confidence interval - CI = 14.9-25.2), and the median survival after reoperation was 9.1 months (95%CI: 2.8-15.4). The performance of adjuvant treatment after the first operation was the single factor associated with overall survival on multivariate analysis (relative risk - RR = 0.3; 95%CI = 0.2-0.7); p = 0.005).
  
  
  CONCLUSIONS
  The length of survival of patients subjected to reoperation for glioblastoma at a Brazilian public healthcare service was similar to the length reported in the literature. Reoperation should be considered as a therapeutic option for selected patients.
authors.affiliation: Universidade Federal de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Willey Gonçalves
authors.initials: WG
authors.lastname: Zanovello
authors.affiliation: Universidade Federal de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Suzana M F
authors.initials: SM
authors.lastname: Malheiros
authors.affiliation: Universidade Federal de São Paulo, Departamento de Patologia, São Paulo SP, Brasil.
authors.forename: João Norberto
authors.initials: JN
authors.lastname: Stavale
authors.affiliation: Universidade Federal de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Orestes P
authors.initials: OP
authors.lastname: Lanzoni
authors.affiliation: Universidade Federal de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Miguel M
authors.initials: MM
authors.lastname: Canteras
authors.affiliation: Universidade Federal de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Adrialdo J
authors.initials: AJ
authors.lastname: Santos
authors.affiliation: Universidade Federal de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Felipe
authors.initials: F
authors.lastname: Slaviero
authors.affiliation: Universidade Federal de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fernandes
authors.affiliation: Universidade Federal de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Cavalheiro
authors.affiliation: Universidade Federal de São Paulo, Departamento de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Manoel A de
authors.initials: MA
authors.lastname: Paiva
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality* / Q000601:surgery / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D005260:Female; D005909:Glioblastoma / Q000401:mortality* / Q000601:surgery / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000601:surgery; D018365:Neoplasm, Residual; D012086:Reoperation / Q000401:mortality* / Q000592:standards; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult