Impact of extent of resection on outcome from glioblastoma using the RANO resect group classification system: a retrospective, population-based cohort study.

Autor:	Bjorland LS; Department of Oncology, Stavanger University Hospital, Stavanger, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway., Mahesparan R; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway., Fluge Ø; Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Science, University of Bergen, Bergen, Norway., Gilje B; Department of Oncology, Stavanger University Hospital, Stavanger, Norway., Dæhli Kurz K; Stavanger Medical Imaging Laboratory (SMIL), Department of Radiology, Stavanger University Hospital, Stavanger, Norway.; Institute for Data- and Electrotechnology, Faculty of Science and Technology, University of Stavanger, Stavanger, Norway., Farbu E; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Department of Neurology, Stavanger University Hospital, Stavanger, Norway.
Jazyk:	angličtina
Zdroj:	Neuro-oncology advances [Neurooncol Adv] 2023 Sep 26; Vol. 5 (1), pp. vdad126. Date of Electronic Publication: 2023 Sep 26 (Print Publication: 2023).
DOI:	10.1093/noajnl/vdad126
Abstrakt:	Background: Extent of resection (EOR) is associated with survival in glioblastoma. A standardized classification for EOR was lacking until a system was recently proposed by the response assessment in neuro-oncology (RANO) resect group. We aimed to assess EOR in an unselected glioblastoma cohort and use this classification system to evaluate the impact on survival in a real-world setting. Methods: We retrospectively identified all patients with histologically confirmed glioblastoma in Western Norway between 1.1.2007 and 31.12.2014. Volumetric analyses were performed using a semi-automated method. EOR was categorized according to the recent classification system. Kaplan-Meier method and Cox proportional hazard ratios were applied for survival analyses. Results: Among 235 included patients, biopsy (EOR class 4) was performed in 50 patients (21.3%), submaximal contrast enhancement (CE) resection (EOR class 3) in 66 patients (28.1%), and maximal CE resection (EOR class 2) in 119 patients (50.6%). Median survival was 6.2 months, 9.2 months, and 14.9 months, respectively. Within EOR class 2, 80 patients underwent complete CE resection (EOR class 2A) and had a median survival of 20.0 months, while 39 patients had a near-total CE resection, with ≤1 cm 3 CE residual volume (EOR class 2B), and a median survival of 11.1 months, P < 0.001. The 2-year survival rate in EOR class 2A was 40.0%, compared to 7.7% in EOR class 2B. Conclusions: RANO resect group classification for the extent of resection reflected outcome from glioblastoma in a real-world setting. There was significantly superior survival after complete CE resection compared to near-total resection. Competing Interests: The authors have no relevant financial or nonfinancial interests to disclose. (© The Author(s) 2023. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.)
Databáze:	MEDLINE
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