NC-09 * THE IMPACT OF SUPRATOTAL RESECTION FOR GLIOBLASTOMA

Abstract

Clinical benefits of supratotal resection (SR) for glioblastoma (GBM) are unclear, although SR for low-grade glioma extends overall survival (OS). We hypothesized that SR for GBM contributes to suppression of local recurrence. In this study, we investigated the clinical benefits of SR for GBM. We reviewed 21 patients with GBM (14 males, 7 females, 34-79 years old) received tumor removal with no residual tumor followed by standard adjuvant radio-chemotherapy in our hospital from 2008 through 2013. Depending on the post-operative MRI, we classified the extent of surgery into SR defined as sufficient resection beyond the margin of tumor or total resection (TR) defined as resection margins at the level of tumor border. The extent of resection (EOR) was assessed by quantifying resection cavity / tumor volume using MRI images with Brainlab iPlan software. Additionally, the information of pre/post-operative KPS, complication rate, progression free survival (PFS) and OS were collected. SR group included 5 cases (5 males, average 70.0 years old), whereas TR group included 16 cases (9 males, 7 females, average 63.6 years old). There were no significant differences in age, pre-operative KPS and methylation status of MGMT promoter. In SR group, tumor volume tended to be smaller (SR:TR = 29.2 ± 16.1cm3:39.9 ± 31.2cm3) and EOR was bigger as compared with TR group (SR:TR = 233.7 ± 34.7°:127.4 ± 21.9°). No significant difference was observed in PFS (SR:TR = median 7 months:7.5 months). However, OS tended to be shorter in SR group than in TR group (SR:TR = median 12 months:16 months). Post-operative KPS tended to be lower in SR groups. Complication rate were similar between SR and TR. Our limited data suggests no clinical benefits of SR for GBM.