The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient. The impact of the neurosurgery in elderly patients with glioblastoma multiforme (GBM) is still unclear. The objective of this systematic review was to evaluate the overall survival of patients over 65 years old submitted to GBM surgical treatment and analyze the rates of postoperative complications in this population. A search on the Medline, Cochrane e Google Scholar electronic databases between January 2005 and April 2018 identified seven studies that evaluated the neurosurgical treatment of patients older than 65 years with GBM. Surgical procedures included complete or partial resection or tumor biopsy. In elderly GBM patients, total surgical resection of the tumor was associated with longer overall postoperative survival when compared with the partial resection or biopsy. Based on this study, neurosurgery is recommended to increase the overall survival of elderly patients with GBM and a good overall preoperative condition. The high rate of complications in this population should be taken into consideration for the surgical decision. The details of the methodology of this guideline are set out in Annex I.
O diagnóstico tardio é um fator que determina mau prognóstico para os pacientes com câncer, especialmente para tumores cerebrais agressivos, como o glioblastoma (GBM), em que a taxa de sobrevida média, em 1 ano, chega a 30% dos casos. Neste contexto, a busca por biomarcadores para detecção precoce da doença e avaliação prognóstica é de fundamental importância para melhorar os resultados clínicos dos pacientes com GBM. O presente estudo trata-se de uma revisão bibliográfica do tipo narrativa. Foram analisados 33 artigos, selecionados entre os anos de 2007 a 2022, considerando a proteína BAP1 e sua relação com o estabelecimento do GBM. O gene BAP1, localizado no locus 3p21.1, codifica o domínio catalítico primário da proteína BAP1, que tem como função remover sinais de ubiquitina de substratos proteicos. BAP1 atua em diversas vias de sinalização celular, tais como: morte celular, controle do ciclo e proliferação celular, resposta de danos ao DNA e modificação da cromatina e quando alterado favorece o estabelecimento de uma neoplasia. Embora, a proteína BAP1 tenha sido considerada como um biomarcador tumoral candidato a avaliar prognóstico em diferentes tipos de tumores, mais investigações são necessárias para elucidar melhor as interações desse alvo e seu potencial papel como biomarcador em tumores do sistema nervoso central, incluindo GBM.
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