PP36. IMPROVED GLIOBLASTOMA SURVIVAL FOLLOWING THE INTRODUCTION OF A SUBSPECIALISED SURGICAL HIGH GRADE BRAIN TUMOUR SERVICE

Abstract

AIM: Glioblastoma (GBM) is a highly aggressive primary brain tumour. Whilst the prognosis remains poor, it has been noted in our centre that the three year survival of patients with GBM has improved over time. The aim of this study is to quantify the improved survival and identify causative factors. METHODS: We performed a retrospective analysis of all patients in our centre who were histologically proven to have GBM following surgery between 2008–2012 (n=353, 5 lost to follow up and excluded). Temozolomide was available throughout this time-period. We analysed survival trends and the effect of different factors including the type of surgery (biopsy vs debulking) and the introduction of a subspecialised surgical high grade brain tumour service. RESULTS: Better outcomes were seen with patients who underwent surgical debulking (median survival 11.4 months, 3 year survival 13.9%) compared to biopsy alone (median survival 3.9 months, 3 year survival 3.1%, p=0.00). There was also a survival difference between patients who were treated before and after the introduction of a high grade brain tumour service. Median survival improved from 7.0 to 8.8 months and 3 year survival improved from 7.8% to 13.1% (p=0.03). The survival of patients undergoing biopsy changed little before and after the service was introduced but the median survival of patients undergoing debulking increased from 9.7 months (3 year survival 11.5%) to 13.9 months (3 year survival 17.7%, p=0.01). CONCLUSION: Debulking confers significant benefit compared to biopsy alone. The introduction of a subspecialised high grade brain tumour service has led to improvement in survival. This is especially true for patients fit enough to undergo surgical debulking. A subspecialised high grade brain tumour service should be established in all neurosurgical units.