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Role of postoperative tumor volume in patients with MGMT-unmethylated glioblastoma

  • Clinical Study
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Abstract

Purpose

The aim of this study is to investigate the association between postoperative tumor volume and overall survival (OS) of O6-methylguanine DNA methyltransferase (MGMT)-unmethylated glioblastoma patients.

Methods

One 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.

Results

Complete 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).

Conclusions

Although 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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Authors and Affiliations

  1. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany

    Arthur H. A. Sales, Melanie Barz, Yu-Mi Ryang, Bernhard Meyer & Jens Gempt

  2. Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Stefanie Bette & Benedikt Wiestler

  3. Department of Radiology, University Hospital, LMU Munich, Munich, Germany

    Thomas Huber

  4. Department of Neurology, Technische Universität München, Munich, Germany

    Friederike Schmidt-Graf

  5. Department of Neuropathology, Technische Universität München, Munich, Germany

    Friederike Liesche

  6. Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Stephanie E. Combs

  7. Department of Radiation Sciences (DRS), Institute of Innovative Radiotherapy (iRT), Helmholtz Zentrum München, Munich, Germany

    Stephanie E. Combs

  8. Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, Munich, Germany

    Stephanie E. Combs

Authors
  1. Arthur H. A. Sales
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Corresponding author

Correspondence to Jens Gempt.

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Conflict of interest

Arthur H.A. Sales, Stefanie Bette, Melanie Barz, Thomas Huber, Benedikt Wiestler, Yu-Mi Ryang, Stephanie E.Combs, Friederike Schmidt-Graf, Bernhard Meyer, and Jens Gempt: SB, JG, and BM work as consultants for Brainlab (Brainlab AG, Munich). TH works as consultant for Smart Reporting GmbH (Munich, Germany).

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Sales, A.H.A., Bette, S., Barz, M. et al. Role of postoperative tumor volume in patients with MGMT-unmethylated glioblastoma. J Neurooncol 142, 529–536 (2019). https://doi.org/10.1007/s11060-019-03124-z

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  • DOI: https://doi.org/10.1007/s11060-019-03124-z

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