Abstract
The impact of different patterns of glioblastoma (GBM) recurrence has not yet been fully established in patients suitable for a second surgery. Through the present observational study carried out at Pisa University Hospital, we aimed to investigate how different patterns of GBM failure influence second surgery outcomes. Overall survival (OS) and post-recurrence survival (PRS) were assessed according to clinical characteristics, including pattern of recurrence, in a prospective cohort of recurrent GBM patients. Survival curves were calculated using the Kaplan-Meier method and the log-rank test was applied to evaluatethe differences between curves. Patients with local recurrence had better OS than patients with non-local one, 24.1 versus 18.2months, respectively [P = 0.015, HR = 1.856 (1.130-3.050)]. The second surgery conferred an advantage in OS respect to non-operated patients, however, this advantage was more evident in patients with local recurrence [P = 0.002 with HR 0.212 (95% CI 0.081-0.552) and P = 0.029 with HR = 0.522 (95% CI 0.291-0.936), respectively]. The recurrence pattern can influence the outcome of patients with recurrent GBM suitable for a second surgery.
Highlights
Glioblastoma (GBM) is the most aggressive primary brain tumor, and it is characterised by a poor prognosis [1,2,3]
The local recurrence pattern could be a promising field of interest for patients with recurrent GBM suitable for a second surgery
From July 2015 to September 2020, 156 patients were referred to the Radiotherapy Unit of Pisa University Hospital for recurrent GBM and were subsequently included in the present study
Summary
Glioblastoma (GBM) is the most aggressive primary brain tumor, and it is characterised by a poor prognosis [1,2,3]. Following upfront surgery, combined radio-chemotherapy with temozolomide according to the Stupp regimen represents the standard post-operative therapy. Recent studies reported different overall survival (OS) time after disease recurrence according to patterns of failure, suggesting a possible correlation between clinical behaviour and underlying differences in tumor biology. The literature on this topic is still limited, and the impact of the different patterns of recurrence has not yet been investigated in patients suitable for a second surgery. The impact of different patterns of glioblastoma (GBM) recurrence has not yet been fully established in patients suitable for a second surgery. Through the present observational study carried out at Pisa University Hospital, we aimed to examine the impact of different patterns of GBM failure on patients’ survival and second surgery outcomes
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