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Cited by 300

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.

Correlation of the extent of tumor volume resection and patient survival in surgery of glioblastoma multiforme with high-field intraoperative MRI guidance

Open access
Kuhnt, D., Becker, A., Ganslandt, O., Bauer, M., Buchfelder, M., Nimsky, C.·2011·Neuro-Oncology
DOI 10.1093/neuonc/nor133
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Abstract

Extent of resection (EOR) still remains controversial in therapy of glioblastoma multiforme (GBM). However, an increasing number of studies favor maximum EOR as being associated with longer patient survival. One hundred thirty-five GBM patients underwent tumor resection aided by 1.5T intraoperative MRI (iMRI) and integrated multimodal navigation. Tumor volume was quantified by manual segmentation. The influences of EOR, patient age, recurrent tumor, tumor localization, and gender on survival time were examined. Intraoperative MRI detected residual tumor volume in 88 patients. In 19 patients surgery was continued; further resection resulted in final gross total resection (GTR) for 9 patients (GTR increased from 47 [34.80%] to 56 [41.49%] patients). Tumor volumes were significantly reduced from 34.25 ± 23.68% (first iMRI) to 1.22 ± 16.24% (final iMRI). According to Kaplan-Meier estimates, median survival was 14 months (95% confidence interval [CI]: 11.7-16.2) for EOR ≥ 98% and 9 months (95% CI: 7.4-10.5) for EOR <98% (P< .0001); it was 9 months (95% CI: 7.3-10.7) for patients ≥ 65 years and 12 months (95% CI: 8.4-15.6) for patients <65 years (P < .05). Multivariate analysis showed a hazard ratio of 0.39 (95% CI: 0.24-0.63; P = .001) for EOR ≥ 98% and 0.61 (95% CI: 0.38-0.97; P < .05) for patient age <65 years. To our knowledge, this is the largest study including correlation of iMRI, tumor volumetry, and survival time. We demonstrate that navigation guidance and iMRI significantly contribute to optimal EOR with low postoperative morbidity, where EOR ≥ 98% and patient age <65 years are associated with significant survival advantages. Thus, maximum EOR should be the surgical goal in GBM surgery while preserving neurological function.

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Metadata

Authors
Kuhnt, D., Becker, A., Ganslandt, O., Bauer, M., Buchfelder, M., & Nimsky, C.
Venue
Neuro-Oncology
Publisher
Oxford University Press (OUP)
Published
2011-09-12
Volume
13
Issue
12
Pages
1339-1348
ISSN
  • 1522-8517 (ISSN-L)
  • 1523-5866
DOI
10.1093/neuonc/nor133
OpenAlex
W2155197551
Cited by
300
References
30
FWCI
8.38
Type
journal article
Language
en
Open access
green

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Kuhnt, D., Becker, A., Ganslandt, O., Bauer, M., Buchfelder, M., & Nimsky, C. (2011). Correlation of the extent of tumor volume resection and patient survival in surgery of glioblastoma multiforme with high-field intraoperative MRI guidance. Neuro-Oncology. https://doi.org/10.1093/neuonc/nor133

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