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

01-07-2020 | Glioblastoma | Clinical Study

Survival benefit of lobectomy for glioblastoma: moving towards radical supramaximal resection

Authors: Ashish H. Shah, Anil Mahavadi, Long Di, Alexander Sanjurjo, Daniel G. Eichberg, Veronica Borowy, Javier Figueroa, Evan Luther, Macarena Ines de la Fuente, Alexa Semonche, Michael E. Ivan, Ricardo J. Komotar

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

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Abstract

Purpose

Extent of resection remains a paramount prognostic factor for long-term outcomes for glioblastoma. As such, supramaximal resection or anatomic lobectomy have been offered for non-eloquent glioblastoma in an attempt to improve overall survival. Here, we conduct a propensity-matched analysis of patients with non-eloquent glioblastoma who underwent either lobectomy or gross total resection of lesion to investigate the efficacy of supramaximal resection of glioblastoma.

Methods

Patients who underwent initial surgery for gross total resection or lobectomy for non-eloquent glioblastoma at our tertiary care referral center from 2010 to 2019 were included for this propensity-matched survival analysis. Propensity scores were generated with the following covariates: age, location, preoperative KPS, product of perpendicular maximal tumor diameters, and product of perpendicular FLAIR signal diameters. Inverse probability of treatment weighting (IPTW) with generated propensity scores was used to compare progression-free survival and overall survival.

Results

Sixty-nine patients were identified who underwent initial resection of glioblastoma for non-eloquent glioblastoma from 2010 to 2019 (GTR = 37, lobectomy = 32). Using IPTW, overall survival (30.7 vs. 14.1 months) and progression-free survival (17.2 vs. 8.1 months were significantly higher in the lobectomy cohort compared to the GTR group (p < 0.001). There was no significant difference in pre-op or post-op KPS or complication rates between the two groups.

Conclusion

Our propensity-matched study suggests that lobectomy for non-eloquent glioblastoma confers an added survival benefit compared to GTR alone. For patients with non-eloquent glioblastoma, a supramaximal resection by means of an anatomic lobectomy should be considered as a primary surgical treatment in select patients if feasible.
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Metadata
Title
Survival benefit of lobectomy for glioblastoma: moving towards radical supramaximal resection
Authors
Ashish H. Shah
Anil Mahavadi
Long Di
Alexander Sanjurjo
Daniel G. Eichberg
Veronica Borowy
Javier Figueroa
Evan Luther
Macarena Ines de la Fuente
Alexa Semonche
Michael E. Ivan
Ricardo J. Komotar
Publication date
01-07-2020
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 3/2020
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-020-03541-5

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