PO58RE-DO SURGERY IN PATIENTS WITH GLIOBLASTOMA MULTIFORME - 8 YEARS OF EXPERIENCE FROM A SINGLE CENTRE

Abstract

INTRODUCTION: There remains debate on whether patients with recurrence of glioblastoma multiforme (GBM) should undergo further debulking surgery. Here we present the outcomes for all patients that underwent re-do surgery in a single centre as part of preparations for a randomised trial to investigate the benefits of re-do surgery for GBM. METHOD: Case notes for all patients with a diagnosis of GBM that had more than one debulking operation were reviewed from the last 8 years. RESULTS: 29 patients had a total of 2 debulking procedures and 2 patients had 3 debulking procedures. Excluding 3 patients still alive at the time of this review, median duration of survival from diagnosis was 530 days, and median duration of survival after re-do surgery was 193 days. The median interval between first and second procedures was 345 days. The median age at diagnosis was 52, and the average Karnofsky Performance Status at time of first surgery was 94%, which dropped to 80% prior to re-do surgery. 3 patients (9.6%) developed wound infections after re-do surgery, and 4 patients (12.9%) developed new neurological deficits.Duration of survival after re-do surgery was increased in patients that had Gliadel® wafers placed at the time of re-do surgery from a median of 218 days compared to 165 days in patients where Gliadel® was not used. MGMT methylation status was available for 10 patients who had been operated on since 2012. Patients who were methylated had a median survival of 274 days after re-do surgery (excluding one person who was still alive), compared with 167 days for those who were un-methylated. CONCLUSION: Our single centre experience supports existing data on outcomes following re-do surgery for GBM.