A prospective study of surgical patterns of care for high grade glioma in the current era of multimodality therapy

作者：Nowak A K^*; Maujean J E; Jackson M; Knuckey N

来源：Journal of Clinical Neuroscience, 2011, 18(2): 227-231.

DOI：10.1016/j.jocn.2010.05.009

• Craniotomy
• Glioblastoma multiforme
• High grade glioma
• Patterns of care
• Surgery

Previous surgical patterns of care reports in high grade glioma (HGG) antedated the use of chemo-radiotherapy. This study, from an elective neurosurgical centre serving an isolated population of over 2 million, identified adult patients with HGG from a prospective multidisciplinary database. Of 328 patients in Western Australia who were diagnosed with HGG between 1 June 2006 and 30 June 2008, 283 patients (86%) received care at the study site. A total of 4% were diagnosed on imaging and clinical factors alone; 12% had surgery outside the study site. The remaining 231 patients had 264 surgical procedures; 78% resection and 22% biopsy. Median survival (grade IV) was 9.4 months. Resection predicted improved survival (hazard ratio 0.64; 95% confidence interval 0.4-0.89); however, in multivariable analysis, only age and grade predicted outcome. The proportion of patients having no tissue diagnosis, or biopsy alone, compares favourably with data before the use of chemo-radiotherapy, as does survival. The therapeutic nihilism surrounding HGG may have decreased since the introduction of temozolomide.

• 出版日期2011-2