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Journal of Neuro-Oncology

, Volume 132, Issue 3, pp 419–426 | Cite as

Benefit of re-operation and salvage therapies for recurrent glioblastoma multiforme: results from a single institution

  • M. Azoulay
  • F. Santos
  • G. Shenouda
  • K. Petrecca
  • A. Oweida
  • M. C. Guiot
  • S. Owen
  • V. Panet-Raymond
  • L. Souhami
  • Bassam S. Abdulkarim
Clinical Study

Abstract

The optimal management of recurrent glioblastoma (GBM) has yet to be determined. We aim to assess the benefits of re-operation and salvage therapies (chemotherapy and/or re-irradiation) for recurrent GBM and to identify prognostic factors associated with better survival. All patients who underwent surgery for GBM between January 2005 and December 2012 followed by adjuvant radiotherapy, and who developed GBM recurrence on imaging were included in this retrospective study. Univariate and multivariate analysis was performed using Cox models in order to identify factors associated with overall survival (OS). One hundred and eighty patients treated to a dose of 60 Gy were diagnosed with recurrent GBM. At a median follow-up time of 6.2 months, the median survival (MS) from time of recurrence was 6.6 months. Sixty-nine patients underwent repeat surgery for recurrence based on imaging. To establish the benefits of repeat surgery and salvage therapies, 68 patients who underwent repeat surgery were matched to patients who did not based on extent of initial resection and presence of subventricular zone involvement at recurrence. MS for patients who underwent re-operation was 9.6 months, compared to 5.3 months for patients who did not have repeat surgery (p < 0.0001). Multivariate analysis in the matched pairs confirmed that repeat surgery with the addition of other salvage treatment can significantly affect patient outcome (HR 0.53). Re-operation with additional salvage therapies for recurrent GBM provides survival prolongation at the time of progression.

Keywords

Glioblastoma Recurrence Temozolomide Bevacizumab Surgery Radiation 

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Oncology, Division of Radiation Oncology, Cedars Cancer CentreMcGill University Health CentreMontréalCanada
  2. 2.Department of Oncology, Division of Cancer EpidemiologyMcGill UniversityMontréalCanada
  3. 3.Department of Neurology and Neurosurgery, Montreal Neurological HospitalMcGill UniversityMontréalCanada
  4. 4.Research Institute of the McGill University Health CenterMontreal General HospitalMontréalCanada
  5. 5.Department of Pathology, Montreal Neurological HospitalMcGill UniversityMontréalCanada
  6. 6.Department of Oncology, Division of Medical Oncology, Cedars Cancer CentreMcGill University Health CentreMontréalCanada

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