Akademik Veri Yönetim Sistemi
Brain Sciences, cilt.15, sa.5, 2025 (SCI-Expanded, Scopus)
Background and Objectives: This study aims to evaluate the overall survival benefits of repeat resection in patients with recurrent glioblastoma, IDH-wildtype (rGBM), and to identify factors for long-term survival, including the role of clinical, radiological, and molecular parameters. Methods: This longitudinal matched case-control study included 60 patients with rGBM divided into two groups: one surgery (n = 30) and repeat resection (n = 30). The baseline characteristics, preoperative and postoperative volumes, and molecular markers were assessed. Survival analyses were conducted using the Log-rank test, and associated factors with long-term survival were identified in the repeat resection cohort. Results: The patients who underwent repeat resection had a significantly longer median survival of 23.9 months compared to 9.2 months in the one-surgery group (p < 0.001). Preoperative tumor volume was found to correlate with postoperative residual volume in repeat resections. The patients with no residual contrast-enhancing tumor volume (0 cm3) after repeat resection had a median survival of 19.33 months, while those with any residual volume had a median survival of 10.13 months. The patients with lower KPS (≤70) and GCS (≤13) scores at the time of the repeat resection tended to have shorter survival, underscoring the potential clinical relevance of functional status when evaluating surgical candidacy. Conclusions: Complete repeat resection may improve overall survival in patients with recurrent IDH-wildtype GBM and should be considered earlier as a therapeutic option rather than a diagnostic or salvage procedure. Early surgical intervention, before declines in the KPS and GCS or tumor volumes become unmanageable, may lead to better outcomes. Further studies with larger cohorts are needed to confirm these findings.