Oncological and functional outcomes of supratotal resection of IDH1 wild-type glioblastoma based on 11C-methionine PET: a retrospective, single-center study
| Autor: | Yasuo Iwadate, Tomohiro Yamaki, Tomoo Matsutani, Masayoshi Kobayashi, Seiichiro Hirono, Ayaka Hara, Ko Ozaki |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty IDH1 Science medicine.medical_treatment Contrast Media Single Center Article Resection Young Adult 03 medical and health sciences Medical research Methionine 0302 clinical medicine Temozolomide medicine Humans Carbon Radioisotopes Aged Retrospective Studies Multidisciplinary medicine.diagnostic_test Brain Neoplasms business.industry Middle Aged medicine.disease Isocitrate Dehydrogenase Confidence interval Surgery Radiation therapy Treatment Outcome Outcomes research Positron emission tomography Surgical oncology Positron-Emission Tomography 030220 oncology & carcinogenesis Medicine Female Neoplasm Recurrence Local Glioblastoma business Craniotomy 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Scientific Reports, Vol 11, Iss 1, Pp 1-12 (2021) Scientific Reports |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-021-93986-z |
| Popis: | Purpose. The oncological and functional outcomes in glioblastoma (GBM) patients following supratotal resection (SupTR), involving complete resection of contrast-enhancing enhanced (CE) tumors and areas of methionine (Met) uptake on 11C-met positron emission tomography (Met-PET), are unknown.Methods. We conducted a retrospective review in newly diagnosed, IDH1 wild-type GBM patients, comparing SupTR with gross total resection (GTR), in which only CE tumor tissue was resected. All patients underwent standard radiotherapy and temozolomide treatment, and were followed for tumor recurrence and overall survival (OS).Results. Among the 30 patients included in this study, 7 underwent SupTR and 23 underwent GTR. Awake craniotomy with cortical and subcortical mapping was more frequently performed in the SupTR group than in the GTR group. During the follow-up period, significantly different patterns of disease progression were observed between groups. Although more than 80% of recurrences were local in the GTR group, all recurrences in the SupTR group were distant. Median OS in the GTR and SupTR groups was 18.5 months (95% confidence interval [CI], 14.2-35.1) and not reached (95% CI, 30.5-not estimable), respectively; this difference was statistically significant (p=0.03 by log-rank test). No postoperative neurocognitive decline was evident in patients who underwent SupTR.Conclusion. Compared to GTR alone, aggressive resection of both CE tumors and areas with Met uptake (SupTR) under awake craniotomy with functional mapping results in a survival benefit associated with better local control and neurocognitive preservation. |
| Databáze: | OpenAIRE |
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