Early re-do surgery for glioblastoma is a feasible and safe strategy to achieve complete resection of enhancing tumor.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_E91796B65ACD
Type
Article: article from journal or magazin.
Collection
Publications
Title
Early re-do surgery for glioblastoma is a feasible and safe strategy to achieve complete resection of enhancing tumor.
Journal
PloS one
Author(s)
Schucht P., Murek M., Jilch A., Seidel K., Hewer E., Wiest R., Raabe A., Beck J.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
8
Number
11
Pages
e79846
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Complete resection of enhancing tumor as assessed by early (<72 hours) postoperative MRI is regarded as the optimal result in glioblastoma surgery. As yet, there is no consensus on standard procedure if post-operative imaging reveals unintended tumor remnants.
The current study evaluated the feasibility and safety of an early re-do surgery aimed at completing resections with the aid of 5-ALA fluorescence and neuronavigation after detection of enhancing tumor remnants on post-operative MRI.
From October 2008 to October 2012 a single center institutional protocol offered a second surgery within one week to patients with unintentional incomplete glioblastoma resection. We report on the feasibility of the use 5-ALA fluorescence guidance, the extent of resection (EOR) rates and complications of early re-do surgery.
Nine of 151 patients (6%) with glioblastoma resections had an unintentional tumor remnant with a volume >0.175 cm(3). 5-ALA guided re-do surgery completed the resection (CRET) in all patients without causing neurological deficits, infections or other complications. Patients who underwent a re-do surgery remained hospitalized between surgeries, resulting in a mean length of hospital stay of 11 days (range 7-15), compared to 9 days for single surgery (range 3-23; p=0.147).
Our early re-do protocol led to complete resection of all enhancing tumor in all cases without any new neurological deficits and thus provides a similar oncological result as intraoperative MRI (iMRI). The repeated use of 5-ALA induced fluorescence, used for identification of small remnants, remains highly sensitive and specific in the setting of re-do surgery. Early re-do surgery is a feasible and safe strategy to complete unintended subtotal resections.
Keywords
Aged, Female, Glioblastoma/surgery, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neurosurgical Procedures/methods, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
31/08/2020 13:02
Last modification date
10/11/2020 7:26
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