Timing of glioblastoma surgery and patient outcomes: a multicenter cohort study

Autor: Frederik Barkhof, Marnix G. Witte, Merijn E De Swart, Barbara Kiesel, Roelant S Eijgelaar, Wimar A. van den Brink, Alfred Kloet, Philip C. De Witt Hamer, Emmanuel Mandonnet, Marjolein Visser, Hilko Ardon, Marco Conti Nibali, Shawn L. Hervey-Jumper, Wim Bouwknegt, Marco Rossi, L Bello, Georg Widhalm, Tommaso Sciortino, W. Peter Vandertop, Mitchel S. Berger, Albert J S Idema, Domenique M J Müller, Michiel Wagemakers, Julia Furtner, Pierre A. Robe, Seunggu J. Han
Přispěvatelé: Neurosurgery, Surgery, Radiology and nuclear medicine, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Neuroinfection & -inflammation, CCA - Cancer Treatment and quality of life, Amsterdam Neuroscience - Neurovascular Disorders, Amsterdam Neuroscience - Systems & Network Neuroscience, ANS - Neurovascular Disorders, ANS - Systems & Network Neuroscience, CCA - Cancer Treatment and Quality of Life
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Neuro-oncology advances, 3(1). Oxford University Press
Müller, D M J, De Swart, M E, Ardon, H, Barkhof, F, Bello, L, Berger, M S, Bouwknegt, W, Van den Brink, W A, Conti Nibali, M, Eijgelaar, R S, Furtner, J, Han, S J, Hervey-Jumper, S, Idema, A J S, Kiesel, B, Kloet, A, Mandonnet, E, Robe, P A J T, Rossi, M, Sciortino, T, Vandertop, W P, Visser, M, Wagemakers, M, Widhalm, G, Witte, M G & De Witt Hamer, P C 2021, ' Timing of glioblastoma surgery and patient outcomes : a multicenter cohort study ', Neuro-oncology advances, vol. 3, no. 1, pp. vdab053 . https://doi.org/10.1093/noajnl/vdab053
Neuro-oncology advances, 3(1):vdab053. Oxford University Press
Neuro-oncology Advances
ISSN: 2632-2498
DOI: 10.1093/noajnl/vdab053
Popis: BackgroundThe impact of time-to-surgery on clinical outcome for patients with glioblastoma has not been determined. Any delay in treatment is perceived as detrimental, but guidelines do not specify acceptable timings. In this study, we relate the time to glioblastoma surgery with the extent of resection and residual tumor volume, performance change, and survival, and we explore the identification of patients for urgent surgery.MethodsAdults with first-time surgery in 2012–2013 treated by 12 neuro-oncological teams were included in this study. We defined time-to-surgery as the number of days between the diagnostic MR scan and surgery. The relation between time-to-surgery and patient and tumor characteristics was explored in time-to-event analysis and proportional hazard models. Outcome according to time-to-surgery was analyzed by volumetric measurements, changes in performance status, and survival analysis with patient and tumor characteristics as modifiers.ResultsIncluded were 1033 patients of whom 729 had a resection and 304 a biopsy. The overall median time-to-surgery was 13 days. Surgery was within 3 days for 235 (23%) patients, and within a month for 889 (86%). The median volumetric doubling time was 22 days. Lower performance status (hazard ratio [HR] 0.942, 95% confidence interval [CI] 0.893–0.994) and larger tumor volume (HR 1.012, 95% CI 1.010–1.014) were independently associated with a shorter time-to-surgery. Extent of resection, residual tumor volume, postoperative performance change, and overall survival were not associated with time-to-surgery.ConclusionsWith current decision-making for urgent surgery in selected patients with glioblastoma and surgery typically within 1 month, we found equal extent of resection, residual tumor volume, performance status, and survival after longer times-to-surgery.
Databáze: OpenAIRE
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