![]() ![]() Studies that included other brain tumors.Īfter removing duplicate records, all titles and abstracts were screened by two authors (MA and MS). Studies discussing Recurrent or multiple GBM. Studies that selectively examined GBM in a non-eloquent area. Systematic reviews, technical notes, letters, and comments. Types of outcome measures Survival rate after GBM resection. Types of interventions Surgical excision of newly diagnosed GBM. Types of participants Adult patients with histopathologically confirmed GBM. Types of studies All published studies from January 2009 to January 2020 concerning GBM resection and survival including randomized controlled studies, cohort studies, and case series. The following electronic databases were searched on 1 February 2020: PubMed, Google Scholar, MEDLINE, Embase, and science Direct, using the keywords as glioblastoma malignant glioma survival surgical outcome prognosis extent of resection tumor excision Debulking GBM malignant glioma microsurgery. The present study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. īecause of this continuing practice variation regarding the extent of GBM resection, we sought to systematically examine the recent literature to evaluate the impact of the extent of resection of primary GBM on patients’ survival. In addition, the overall survival of patients with GBM varies significantly and there are long survivors in spite of incomplete resection. There is no consensus on the definition of gross total resection of GBM, hence the widespread practice variation among neurosurgeons. Moreover, it is thoroughly recognized that GBM is a diffusely infiltrating neoplasm that typically invades multiple lobes of the brain on diagnosis. The current first-line treatment for newly diagnosed GBM is composed of maximal safe tumor resection, followed by combined radiotherapy and adjuvant temozolomide. The clinical presentation of a patient with a newly diagnosed primary GBM is dependent on the size, location, and degree of infiltration of the tumor. The recent WHO Classification of Tumors of the central nervous system (CNS) diagnosed glioblastoma in the setting of an IDH-wildtype diffuse and astrocytic glioma in adults with microvascular proliferation or necrosis or TERT promoter mutation or EGFR gene amplification or + 7/− 10 chromosome copy number changes. Glioblastoma (GBM) constitutes the most common primary malignant brain tumor in adults and continues to represent a great challenge for neurosurgeons. Thus, prospective randomized controlled trials are required to investigate both the safety and the survival benefit of GTR of glioblastoma. Additionally, no data on patients’ quality of life were reported across the included studies. However, the quality of evidence of the available studies was of low certainty. The outcome results revealed that gross total resection was insignificantly different than incomplete resection on survival among the included cases ( P value: 0.47). ![]() The quality of evidence of the available studies was of low certainty. Using the random-effects model, the outcome results revealed that GTR was insignificantly different than incomplete resection on survival among the included cases ( P value: 0.47). incomplete resection) was 28.7 versus 13.5 months. The mean progression-free survival for GTR versus incomplete resection was 10 versus 6.3 months, and the mean overall survival (GTR vs. A total of 1247 patients underwent gross total resection (GTR) of the GBM, and 1002 experienced an incomplete resection. The included studies involved a total of 2249 patients. Eight studies met our selection criteria. The data synthesis was performed using the random-effects model in Review Manager (version 5.3 Cochrane Collaboration). We examined all the published studies from January 2009 to January 2020 concerning primary glioblastoma resection and survival. Because of the continuing practice variation regarding the extent of glioblastoma (GBM) resection, we sought to systematically examine the recent literature to evaluate the impact of the extent of resection of primary GBM on patients’ survival.
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