Residual enhancing disease after surgery for glioblastoma: evaluation of practice in the United Kingdom
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Background
A growing body of clinical data highlights the prognostic importance of achieving gross total resection (GTR) in patients with glioblastoma. The aim of this study was to determine nationwide practice and attitudes towards achieving GTR and dealing with residual enhancing disease.
Methods
The study was in 2 parts: an electronic questionnaire sent to United Kingdom neuro-oncology surgeons to assess surgical practice followed by a 3-month prospective, multicenter observational study of current neurosurgical oncology practice.
Results
Twenty-seven surgeons representing 22 neurosurgical units completed the questionnaire. Prospective data were collected for 113 patients from 15 neurosurgical units. GTR was deemed to be achieved at time of surgery in 82% (91/111) of cases, but in only 45% (36/80) on postoperative MRI. Residual enhancing disease was deemed operable in 16.3% (13/80) of cases, however, no patient underwent early repeat surgery for residual enhancing disease. The most commonly cited reason (38.5%, 5/13) was perceived lack of clinical benefit.
Conclusion
There is a subset of patients for whom GTR is thought possible, but not achieved at surgery. For these patients, early repeat resection may improve overall survival. Further prospective surgical research is required to better define the prognostic implications of GTR for residual enhancing disease and examine the potential benefit of this early re-intervention.
A growing body of clinical data highlights the prognostic importance of achieving gross total resection (GTR) in patients with glioblastoma. The aim of this study was to determine nationwide practice and attitudes towards achieving GTR and dealing with residual enhancing disease.
Methods
The study was in 2 parts: an electronic questionnaire sent to United Kingdom neuro-oncology surgeons to assess surgical practice followed by a 3-month prospective, multicenter observational study of current neurosurgical oncology practice.
Results
Twenty-seven surgeons representing 22 neurosurgical units completed the questionnaire. Prospective data were collected for 113 patients from 15 neurosurgical units. GTR was deemed to be achieved at time of surgery in 82% (91/111) of cases, but in only 45% (36/80) on postoperative MRI. Residual enhancing disease was deemed operable in 16.3% (13/80) of cases, however, no patient underwent early repeat surgery for residual enhancing disease. The most commonly cited reason (38.5%, 5/13) was perceived lack of clinical benefit.
Conclusion
There is a subset of patients for whom GTR is thought possible, but not achieved at surgery. For these patients, early repeat resection may improve overall survival. Further prospective surgical research is required to better define the prognostic implications of GTR for residual enhancing disease and examine the potential benefit of this early re-intervention.
Date Issued
2018-06-01
Date Acceptance
2017-09-01
Citation
NEURO-ONCOLOGY PRACTICE, 2018, 5 (2), pp.74-81
ISSN
2054-2577
Publisher
Oxford University Press
Start Page
74
End Page
81
Journal / Book Title
NEURO-ONCOLOGY PRACTICE
Volume
5
Issue
2
Copyright Statement
© 2017 The Author(s). Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices). This is a pre-copy-editing, author-produced version of an article accepted for publication in Neuro Oncology Practice following peer review. The definitive publisher-authenticated version Ruichong Ma, Aswin Chari, Paul M Brennan, Andrew Alalade, Ian Anderson, Anna Solth, Hani J Marcus, Colin Watts, British Neurosurgical Trainee Research Collaborative; Residual enhancing disease after surgery for glioblastoma: evaluation of practice in the United Kingdom, Neuro-Oncology Practice, Volume 5, Issue 2, 10 May 2018, Pages 74–81, is available online at: https://dx.doi.org/10.1093/nop/npx023
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices). This is a pre-copy-editing, author-produced version of an article accepted for publication in Neuro Oncology Practice following peer review. The definitive publisher-authenticated version Ruichong Ma, Aswin Chari, Paul M Brennan, Andrew Alalade, Ian Anderson, Anna Solth, Hani J Marcus, Colin Watts, British Neurosurgical Trainee Research Collaborative; Residual enhancing disease after surgery for glioblastoma: evaluation of practice in the United Kingdom, Neuro-Oncology Practice, Volume 5, Issue 2, 10 May 2018, Pages 74–81, is available online at: https://dx.doi.org/10.1093/nop/npx023
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000432282600003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Neurosciences & Neurology
glioblastoma
glioma surgery
neurooncology
residual enhancing disease
survival
NEWLY-DIAGNOSED GLIOBLASTOMA
SURVIVAL CLINICAL ARTICLE
MAXIMUM-SAFE-RESECTION
GROSS-TOTAL RESECTION
SURGICAL RESECTION
RECURRENT GLIOBLASTOMA
ADJUVANT TEMOZOLOMIDE
RADIATION-THERAPY
MALIGNANT GLIOMA
TUMOR VOLUME
Publication Status
Published
Date Publish Online
2017-09-27