Patterns of intracranial glioblastoma recurrence after aggressive surgical resection and adjuvant Management: Retrospective Analysis of 43 Cases

Yoshiyuki Konishi, Yoshihiro Muragaki, Hiroshi Iseki, Norio Mitsuhashi, Yoshikazu Okada

    Research output: Contribution to journalArticlepeer-review

    27 Citations (Scopus)

    Abstract

    The present retrospective study evaluated the recurrence patterns after aggressive surgical removal of intracranial glioblastomas in 43 consecutive adult patients. The resection rate of the enhanced lesion on magnetic resonance imaging was 100% and 95-99% in 22 and 21 cases, respectively. All patients received postoperative fractionated radiotherapy (60 Gy in 30 fractions) with additional chemotherapy (25 cases) or vaccine therapy (18 cases). During follow-up (median 17 months), tumor recurrence was identified in 33 patients, most frequently regional within the wall of the resection cavity (20 cases). No clinical factor differed significantly between the groups of patients with regional or marginal tumor progression (N = 22) and patients with distant or multiple recurrences (N = 8). Progression-free survival did not differ significantly between these two groups (p = 0.27). However, overall survival was significantly longer (p = 0.04) in patients with regional or marginal tumor progression, and constituted 90% and 54% at 1 and 2 years after surgery, respectively, compared to 75% and 0% in patients with distant or multiple recurrences. Aggressive surgical resection and adjuvant management of intracranial glioblastoma may change its recurrence pattern. Tumor progression appears in the wall of the resection cavity or within 2 cm from its margin in approximately half of patients.

    Original languageEnglish
    Pages (from-to)577-586
    Number of pages10
    JournalNeurologia Medico-Chirurgica
    Volume52
    Issue number8
    DOIs
    Publication statusPublished - 2012

    Keywords

    • Glioblastoma
    • Gross total resection
    • Progression
    • Recurrence
    • Survival

    ASJC Scopus subject areas

    • Surgery
    • Clinical Neurology

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