Surgeon experience in glioblastoma surgery of the elderly—a multicenter, retrospective cohort study.

Autor: Pöppe, Johannes P., Machegger, Lukas, Steinbacher, Jürgen, Stefanits, Harald, Eisschiel, Sophie, Gruber, Andreas, Demetz, Matthias, Ladisich, Barbara, Kraus, Theo F.J., Weis, Serge, Spiegl-Kreinecker, Sabine, Romagna, Alexander, Griessenauer, Christoph J., Jahromi, Behnam Rezai, Rautalin, Ilari, Niemelä, Mika, Korja, Miikka, Schwartz, Christoph
Zdroj: Journal of Neuro-Oncology; Feb2023, Vol. 161 Issue 3, p563-572, 10p
Abstrakt: Purpose: To assess the impact of individual surgeon experience on overall survival (OS), extent of resection (EOR) and surgery-related morbidity in elderly patients with glioblastoma (GBM), we performed a retrospective case-by-case analysis. Methods: GBM patients aged ≥ 65 years who underwent tumor resection at two academic centers were analyzed. The experience of each neurosurgeon was quantified in three ways: (1) total number of previously performed glioma surgeries (lifetime experience); (2) number of surgeries performed in the previous five years (medium-term experience) and (3) in the last two years (short-term experience). Surgeon experience data was correlated with survival (OS) and surrogate parameters for surgical quality (EOR, morbidity). Results: 198 GBM patients (median age 73.0 years, median preoperative KPS 80, IDH-wildtype status 96.5%) were included. Median OS was 10.0 months (95% CI 8.0–12.0); median EOR was 89.4%. Surgery-related morbidity affected 19.7% patients. No correlations of lifetime surgeon experience with OS (P =.693), EOR (P =.693), and surgery-related morbidity (P =.435) were identified. Adjuvant therapy was associated with improved OS (P <.001); patients with surgery-related morbidity were less likely to receive adjuvant treatment (P =.002). In multivariable testing, adjuvant therapy (P <.001; HR = 0.064, 95%CI 0.028–0.144) remained the only significant predictor for improved OS. Conclusion: Less experienced neurosurgeons achieve similar surgical results and outcome in elderly GBM patients within the setting of academic teaching hospitals. Adjuvant treatment and avoidance of surgery-related morbidity are crucial for generating a treatment benefit for this cohort. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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