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Sales, Arthur H. A.; Bette, Stefanie; Barz, Melanie; Huber, Thomas; Wiestler, Benedikt; Ryang, Yu-Mi; Schmidt-Graf, Friederike; Liesche, Friederike; Combs, Stephanie E.; Meyer, Bernhard und Gempt, Jens (2019): Role of postoperative tumor volume in patients with MGMT-unmethylated glioblastoma. In: Journal of Neuro-Oncology, Bd. 142, Nr. 3: S. 529-536

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Abstract

PurposeThe aim of this study is to investigate the association between postoperative tumor volume and overall survival (OS) of O-6-methylguanine DNA methyltransferase (MGMT)-unmethylated glioblastoma patients.MethodsOne hundred-twenty-six patients with MGMT-unmethylated glioblastoma who were treated either with surgical resection or needle biopsy between 2006 and 2015 were included in this retrospective cohort. Pre- and postcontrast T1 weighted images were evaluated in order to determine pre- and postoperative contrast-enhancing tumor volumes (CE-TV). Cox regression models adjusted for other significant prognostic factors were used to investigate the association between postoperative tumor volume and survival.ResultsComplete resection of CE-TV was significantly associated with longer OS in the univariate analysis (HR 0.61;95% CI 0.40-0.94;p=0.02). However, this fact could not be confirmed after adjusting the model for other relevant prognostic factors (HR 1.01;95% CI 0.65-1.55;p=0.962). Postoperative CE-TV was significantly associated with survival in both univariate (HR: 1.04;95% CI 1.025-1.055;p<0.001) and multivariate analyses (HR: 1.027;95% CI 1.005-1.049;p=0.014).ConclusionsAlthough complete resection of tumor tissue was not significantly associated with longer OS in MGMT-unmethylated GBM patients, maximum safe resection should always be attempted, since postoperative tumor volume is strongly associated with OS.

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