P09.35 Gross total resection of glioblastoma multiforme: influencing factors survival outcomes - a single centre experience

摘要

>Objectives: We studied factors influencing the extent of resection of glioblastoma multiforme (GBM) and attendant overall survival (OS) and functional performance. >Methods: Retrospective data were collected on 100 consecutive patients who underwent debulking surgery for histologically proven GBM between September 2013 and February 2016 by sub-specialty surgeons at a single institution. Survival data and correlations were calculated using the Kaplan-Meier and linear regression analyses. >Results: Gross total resection (GTR) with tumour residuum<0.175 cm3 was achieved in 66% of small tumours (<37.2 cm3) whilst in 34% of large tumours (>37.2 cm3) (p<0.05). Volume of tumour residuum was significantly correlated with pre-operative tumour volume (p = 0.01). GTR was achieved in 53% versus 29% of tumours involving single versus multiple lobes respectively (p = 0.08). Comparison of 24 patients with complete resection versus 52 patients with near total resection (thin rim of enhancement) versus 24 patients with subtotal resection did yield significant differences in survival (15.9 vs 13.2 vs 11.1 months, respectively, Log-Rank p = 0.03). We also found significant correlation between post-operative tumour volume and overall survival. >Conclusions: Factors influencing GTR include pre-operative tumour size and involvement of more than one lobe. Categorising patients with respect to complete, near total and subtotal resection did yield small but significant differences in survival, and the size of post-operative tumour volume is correlated with survival.