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01-07-2020 | Glioblastoma | Topic Review

A systematic review and meta-analysis of supratotal versus gross total resection for glioblastoma

Authors: Christina Jackson, John Choi, Adham M. Khalafallah, Carrie Price, Chetan Bettegowda, Michael Lim, Gary Gallia, Jon Weingart, Henry Brem, Debraj Mukherjee

Published in: Journal of Neuro-Oncology | Issue 3/2020

Abstract

Purpose

Due to the infiltrative nature of glioblastoma (GBM) outside of the contrast-enhancing region on MRI, there is interest in exploring supratotal resections (SpTR) that extend beyond the contrast-enhancing portion of the tumor. However, there is currently no consensus on the potential survival benefit of SpTR in GBM compared to gross total resection (GTR). In this study, we compare the impact of SpTR versus GTR on overall survival (OS) of GBM patients.

Methods

We performed a systematic review and meta-analysis of literature published on PubMed, Embase, The Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov, from inception to August 16, 2018, to identify articles comparing OS after SpTR versus GTR.

Results

We identified 8902 unique citations, of which 11 articles met study inclusion criteria. 810 patients underwent SpTR out of a total of 2056 patients. 9 of 11 studies demonstrated improved outcomes with SpTR compared to GTR (median improvement in OS of 10.5 months), with no significant difference in postoperative complication rate. Overall study quality was variable, with ten studies presenting level IV evidence and one study presenting level IIIb evidence. Subgroup meta-analysis based on SpTR definition demonstrated a statistically significant 35% lower risk of mortality in patients who underwent anatomical SpTR compared to patients who underwent GTR (Hazard ratio = 0.65, 95% CI 0.47- 0.91, p = 0.003).

Conclusion

Our systematic review indicates SpTR may be associated with improved OS compared to GTR for GBM, especially with anatomical SpTR. However, this is limited by variable study design and significant clinical and methodological heterogeneity among studies. There is need for prospective clinical data to further guide parameters regarding the use of SpTR in GBM.

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Title: A systematic review and meta-analysis of supratotal versus gross total resection for glioblastoma
Authors: Christina Jackson
John Choi
Adham M. Khalafallah
Carrie Price
Chetan Bettegowda
Michael Lim
Gary Gallia
Jon Weingart
Henry Brem
Debraj Mukherjee
Publication date: 01-07-2020
Publisher: Springer US
Keywords: Glioblastoma
Glioblastoma
Glioblastoma
Published in: Journal of Neuro-Oncology / Issue 3/2020
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-020-03556-y

2024 ASCO Annual Meeting

Springer Medicine

A systematic review and meta-analysis of supratotal versus gross total resection for glioblastoma

Abstract

Purpose

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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