Extent of Resection in Newly Diagnosed Glioblastoma: Impact of a Specialized Neuro-Oncology Care Center

Abstract

Prognostic factors for PFS and OS were age, preoperative KPS, O⁶-methylguanine-DNA-methyltransferase (<i>MGMT</i>) promoter methylation status, isocitrate dehydrogenase 1 (<i>IDH1</i>) mutation status and EOR. Patients with volumetrically defined complete resection had significantly better PFS (9.4 vs. 7.8 months; <i>p</i> = 0.042) and OS (18.4 vs. 14.5 months; <i>p</i> = 0.005) than patients with incomplete resection. The frequency of transient or permanent postoperative neurological deficits was not higher after complete resection in both subcohorts. The frequency of complete resection was significantly higher in subcohort B than in subcohort A (68.2% vs. 34.8%; <i>p</i> = 0.007). Accordingly, subcohort B showed significantly longer PFS (8.6 vs. 7.5 months; <i>p</i> = 0.010) and OS (18.7 vs. 12.4 months; <i>p</i> = 0.001). Multivariate Cox regression analysis showed complete resection, age, preoperative KPS, and <i>MGMT</i> promoter status as independent prognostic factors for PFS and OS. Our data show a higher frequency of complete resection in patients with GBM after the establishment of a series of technical developments that resulted in significantly better PFS and OS without increasing surgery-related morbidity.