Abstract 356P
Background
Glioblastoma multiforme (GBM) is the most common intracranial primary malignant brain tumour. Concurrent chemo-radiation as definitive treatment after maximal debulking is established as first-line treatment standard but recurrences are treated based on institutional experiences with or without surgery before second and susequent line of chemotherapy. In this study we look at our tertiary centre institution experience of recurrent Glioblastoma who underwent redo surgery for first recurrence.
Methods
We retrospectively reviewed the surgical and oncological data for patients at the Royal Stoke university Hospitals who underwent redo surgery for recurrent GBM between 2006 and 2015. These patients (G1) were then compared with a randomly selected control group (G2), who did not have redo surgery but matched the reviewed group by age, primary treatment, PFS. Data on overall survival, progression free survival, extent of surgical resection, postoperative complications was collected.
Results
A total of 30 patients in G1 and 32 patients in G2 were matched. Progression free survival was 25 weeks in G1, overall survival was 109 weeks (range, 45-180) versus 57 weeks (range 28-127) in G1 vs G2 respectively from time of first diagnosis. There was an incidence of 57% complication rate after second surgery (this included haemorrhage, infarction, worsening neurology due to oedema, CSF leak, and wound infection). More than half of the Redo patients went on to have second and subsequent lines of chemotherapy.
Conclusions
In spite of redo surgery in recurrent GBM is variable, our conclusion is that it is a valid option in select group of patients with good performance status and patients who have a longer progression-free survival from primary treatment. It can also help alleviate compressive symptoms. A well-designed randomised control trial in this population would help set the standard of surgical care.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.