A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival.

  title={A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival.},
  author={M Lacroix and Dima Abi‐Said and Daryl R. Fourney and Ziya L. Gokaslan and Wenxin Shi and Franco DeMonte and Frederick F. Lang and Ian E. McCutcheon and Samuel J. Hassenbusch and Eric C. Holland and Kenneth R. Hess and C Michael and D J Miller and Raymond E. Sawaya},
  journal={Journal of neurosurgery},
  volume={95 2},
OBJECT The extent of tumor resection that should be undertaken in patients with glioblastoma multiforme (GBM) remains controversial. The purpose of this study was to identify significant independent predictors of survival in these patients and to determine whether the extent of resection was associated with increased survival time. METHODS The authors retrospectively analyzed 416 consecutive patients with histologically proven GBM who underwent tumor resection at the authors' institution… 

Does Extent of Resection Increase the Survival in Patients with Glioblastoma Multiformis ?

Maximal resection of the tumor volume is an independent variable associated with longer survival times in patient with GBM and gross total resection should be performed whenever possible, although not at the expense of increased morbidity.

Residual tumor volume versus extent of resection: predictors of survival after surgery for glioblastoma.

CE-RTV and EOR were found to be significant predictors of survival after GBM resection, and CERTV was the more significant predictor of survival compared with EOR, suggesting that the volume of residual contrast-enhancing tumor may be a more accurate and meaningful reflection of the pathobiology of GBM.

Survival Outcome and Its Predictors for Treated Patients with Glioblastoma Multiforme-A Single Centre Retrospective Study

  • Medicine
  • 2019
Despite multimodality aggressive management, survival of patients with newly diagnosed Glioblastoma multiforme is poor and predictive factors will help to identify the subgroup of Patients with better survival.

Maximum resection and immunotherapy improve glioblastoma patient survival: a retrospective single-institution prognostic analysis

GTR, proton therapy, and immunotherapy were good prognostic factors in single-center GBM cases and tumor vaccine therapy for GTR cases achieved a notably high median survival time and long-term survival ratio, indicating its usefulness in G TR cases.

Multiple resections for patients with glioblastoma: prolonging survival.

The present study shows that patients with recurrent glioblastoma can have improved survival with repeated resections, and the findings of this study may be limited by an intrinsic bias associated with patient selection.

An extent of resection threshold for newly diagnosed glioblastomas.

For patients with newly diagnosed GBMs, aggressive EOR equates to improvement in overall survival, even at the highest levels of resection, and stepwise improvement in survival was evident even in the 95%-100% EOR range.


The present data provide Level 2b evidence (Oxford Centre for Evidence-based Medicine) that survival depends on complete resection of enhancing tumor in glioblastoma multiforme and treatment bias was demonstrated regarding resection and second-line therapies.

Treatment outcome and prognostic factors of adult glioblastoma multiforme.

Patient-Specific Resection Strategy of Glioblastoma Multiforme: Choice Based on a Preoperative Scoring Scale

GTR was an independent predictor of increased survival for patients with GBM and the risk scoring scale quantified the clinical significance of operation and helped us to project more personalized surgical strategies for individual patients.



Therapy for supratentorial malignant astrocytomas: survival and possible prognostic factors.

A retrospective analysis of patients with pathologically proven supratentorial malignant astrocytomas from January 1981 to December 1990 showed that the duration of symptoms, extent of resection, irradiation and tumor histology were significantly related to the survivalTime, however, gross total resection did not improve the survival time relative to a subtotal resection.

The relationship between survival and the extent of the resection in patients with supratentorial malignant gliomas.

Future reporting of surgical results of patients with gliomas will require stratification by the known prognostic variables of age, histological findings, and performance status to characterize better this subgroup of young patients with favorable histology findings and good performance status for whom surgery is beneficial.

Highly anaplastic astrocytoma: a review of 357 patients treated between 1977 and 1989.

Effect of the extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic astrocytomas.

Gross total resection of supratentorial glioblastomas and anaplastic astrocytomas is feasible and is directly associated with longer and better survival when compared to subtotal resection.

Patient age, histologic features, and length of survival in patients with glioblastoma multiforme

The results suggest that patients whose glioblastomas contained microcysts, pseudopalisading, cells with astrocytic differentiation, and large areas of better differentiated glioma, did better than those patients whose lesions were homogeneously composed of small cells or whose lesion had a small median nuclear size.

Surgical resection and radiation therapy versus biopsy and radiation therapy in the treatment of glioblastoma multiforme.

The comparable survival times for the two groups place doubt on the concept of treating glioblastoma multiforme with cytoreductive surgery, as presently, radiation therapy is the most effective treatment for patients with gliOBlastoma.

The prognostic importance of tumor size in malignant gliomas: a computed tomographic scan study by the Brain Tumor Cooperative Group.

  • J. WoodS. GreenW. Shapiro
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1988
The amount of tumor remaining after surgery is an important baseline variable at the start of RT, and the tumor size 9 weeks following RT is also prognostic, which is concluded to be most important when it leaves the least amount of residual tumor.

Early postoperative magnetic resonance imaging after resection of malignant glioma: objective evaluation of residual tumor and its influence on regrowth and prognosis.

Residual tumor enhancement was the most predictive prognostic factor of survival in patients with glioblastoma, followed by radiotherapy, and Gadolinium-enhanced MRI proved to be extremely valuable for assessing gross residual tumor when performed after the resection of a preoperatively enhancing high-grade glioma.

Reoperation in the treatment of recurrent intracranial malignant gliomas.

Fifty-five consecutive patients with recurrent intracranial malignant gliomas were reoperated at Memorial Sloan-Kettering Cancer Center from 1972 to 1983, finding that the combined use of reoperation and adjuvant therapy prolongs good quality life.

Neurosurgical outcomes in a modern series of 400 craniotomies for treatment of parenchymal tumors.

The finding that gross total resections could be performed in eloquent brain regions with an acceptable level of neurological impairment suggested that the mere presence of a tumor in eloquENT brain does not automatically contraindicate surgery.