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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Does extent of resection impact survival in patients bearing glioblastoma?
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Does extent of resection impact survival in patients bearing glioblastoma?

机译：切除程度是否会影响成胶质母细胞瘤患者的生存？

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The impact of malignant glioma resection on survival is still a matter of controversy. The lack of well-designed prospective studies as well as control of all factors in retrospective studies plays an important role in this debate. Amongst some of these uncontrolled factors, are the inclusion of different histological grades, the lack of objective methods to estimate the extent of resection and unspecified delays in post-operative imaging. We retrospectively reviewed 126 consecutive patients with glioblastoma, operated on by the senior authors at the Centre Hospitalier Universitaire de Sherbrooke, who met the following criteria: >18 years of age, newly diagnosed glioblastoma, pre-operative magnetic resonance imaging (MRI) within 2 weeks prior to surgery, and a post-operative MRI within 72 hours after surgery. Extent of tumour resection was calculated using pre and post-operative tumour delimitation on gadolinium-enhanced T1 MRI in a volumetric analysis. Applying stringent specific inclusion criteria, 126 patients were retained in the analysis. The median overall survival was 271 days and the median extent of resection was 65%. Patients with more than 90% of tumour resection had a significantly better outcome, improving median survival from 225 to 519 days (P=0.006). Other factors that significantly improved survival were the use of radiotherapy, the number of regimens and type of chemotherapy used. A more aggressive approach combining maximal safe resection and use of salvage chemotherapy seems to confer a survival advantage for glioblastoma patients.
机译：恶性神经胶质瘤切除术对生存的影响仍是一个有争议的问题。在回顾性研究中，缺乏精心设计的前瞻性研究以及对回顾性研究中所有因素的控制在这一辩论中起着重要作用。在这些不受控制的因素中，包括不同的组织学等级，缺乏客观的方法来估计切除范围以及术后影像学未明确的延迟。我们回顾性研究了由舍布鲁克大学中心医院的资深作者手术的126例胶质母细胞瘤患者，这些患者符合以下标准：> 18岁，新诊断的胶质母细胞瘤，术前磁共振成像（MRI）在2岁以内手术前几周，以及手术后72小时内进行MRI。在体积分析中，在on增强的T1 MRI上使用术前和术后肿瘤定界来计算肿瘤切除的程度。应用严格的特定纳入标准，将126例患者保留在分析中。中位总生存期为271天，中位切除率为65％。肿瘤切除率超过90％的患者预后明显好转，中位生存期从225天提高到519天（P = 0.006）。显着提高生存率的其他因素是放疗的使用，治疗方案的数量和所用化学疗法的类型。结合最大安全切除和挽救性化疗方法的更具侵略性的方法似乎为胶质母细胞瘤患者带来了生存优势。

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