Survival and Functional Status after Resection of Recurrent Glioblastoma Multiforme

Barker, Fred G.; Chang, Susan M.; Gutin, Philip H.; Malec, Mary; McDermott, Michael W.; Prados, Michael D.; Wilson, Charles B.

doi:10.1097/00006123-199804000-00013

Cited by 304 publications

(177 citation statements)

References 52 publications

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“…Although in our recent study we identified significant differences between recurrent and newly diagnosed glioma patients with respect to neurological outcome and incidence of postoperative ischemic lesions, there are still few and contradictory data available on the resection of recurrent intrinsic brain tumors. 1,2,4,8,15,19,28,29 Ultimately, even though we were able to detect relevant ischemic events by intraoperative monitoring, the key question remains of how to avoid these events. Certainly a meticulous surgical technique tailored to the vascular architecture at risk, whether cortical arteries and draining veins or subcortical perforating arteries, is the mainstay of a safe resection.…”

Section: Discussionmentioning

confidence: 91%

Postoperative ischemic changes after glioma resection identified by diffusion-weighted magnetic resonance imaging and their association with intraoperative motor evoked potentials

Gempt¹,

Krieg

Hüttinger

et al. 2013

JNS

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Object The aim of surgical glioma treatment is the complete resection of tumor tissue while preserving neurological function. Surgery-related neurological deficits arise from direct damage to the cortical or subcortical structures or from ischemia. The authors aimed to assess the incidence of resection-related ischemia of newly diagnosed or recurrent supratentorial gliomas and the sensitivity of intraoperative neuromonitoring (IOM) of motor evoked potentials (MEPs) for detecting such ischemic events and their influence on neurological motor function. Methods Between January 2009 and December 2010, 70 patients with tumors in motor-eloquent brain areas underwent intraoperative MEP monitoring during glioma resection and were examined by early postoperative MRI including diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping. Postoperative areas of restricted diffusion were assessed by investigators blinded to the course of intraoperative MEPs and the neurological course. Results Among the 70 enrolled patients, a MEP amplitude decline below 50% of the baseline level was observed in 21 patients (30%). Sixteen of these patients (76%) had ischemic lesions identified on postoperative MRI scans. Forty-nine patients (70%) showed no decline in MEP amplitude, and only 16 (33%) of these patients harbored ischemic lesions. Moreover, 9 (69%) of 13 patients with a permanent loss of MEP amplitude showed postoperative ischemic lesions. Factors that promoted the occurrence of postoperative infarction were previous radiotherapy and location of the tumor close to the central arteries. Conclusions Alterations in the MEP amplitude during tumor resection and postoperative ischemic lesions are associated with postoperative impairment of motor function. Rather than cortical or subcortical structural damage of eloquent brain tissue alone, peri- or postoperative ischemic lesions play a crucial role in the development of surgery-related motor deficits.

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Section: Discussionmentioning

confidence: 91%

Postoperative ischemic changes after glioma resection identified by diffusion-weighted magnetic resonance imaging and their association with intraoperative motor evoked potentials

Gempt¹,

Krieg

Hüttinger

et al. 2013

JNS

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“…Our patient underwent four surgical procedures and surgical intervention for recurrent GBM was reported in about 28% of cases. Three or more procedures were performed in about 10% of cases (2,8). Our patient benefited from these four surgical procedures and advanced chemotherapeutic regimens.…”

Section: A B Cmentioning

confidence: 86%

Transdural spread of glioblastoma multiforme with endonasal growth in a long-term survivor patient: case report and literature review

D’Elia¹,

Fazzolari²,

Arcovio³

et al. 2014

Turkish Neurosurgery

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“…Therefore, the impact of re-resection by itself is not entirely clear. Barker et al reported the results of re-resection plus individual additional treatment (chemotherapy in 85% of cases) for GBM [37]. Median survival was 36 weeks, suggesting a moderate improvement when compared with a group of 130 patients who received comparable first-line treatment and chemotherapy without re-resection (median survival 23 weeks).…”

Section: Surgerymentioning

confidence: 99%

Unmet needs in the treatment of glioblastoma

Mut

Schiff

2009

Expert Review of Anticancer Therapy

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Survival and Functional Status after Resection of Recurrent Glioblastoma Multiforme

Abstract: Survival after resection of recurrent GM remains poor despite advances in imaging, operative technique, and adjuvant therapies. High-quality survival after resection of recurrence to treat GM seems to have increased significantly since an earlier report from our institution.

Cited by 304 publications

References 52 publications

Postoperative ischemic changes after glioma resection identified by diffusion-weighted magnetic resonance imaging and their association with intraoperative motor evoked potentials

Postoperative ischemic changes after glioma resection identified by diffusion-weighted magnetic resonance imaging and their association with intraoperative motor evoked potentials

Transdural spread of glioblastoma multiforme with endonasal growth in a long-term survivor patient: case report and literature review

Unmet needs in the treatment of glioblastoma

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