Operability of glioblastomas: “sins of action” versus “sins of non-action”
Despite prognosis of glioblastomas is still poor, mounting evidence suggests that more extensive surgical resections are associated with longer life expectancy. However, the surgical indications, at present, are far from uniform and the concept of operability is extremely surgeon-dependant. The resu...
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| Veröffentlicht in: | Neurological sciences 2013-12, Vol.34 (12), p.2107-2116 |
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| creator | Ferroli, Paolo Schiariti, Marco Finocchiaro, Gaetano Salmaggi, Andrea Castiglione, Melina Acerbi, Francesco Tringali, Giovanni Farinotti, Mariangela Broggi, Morgan Roberto, Cordella Maccagnano, Elio Broggi, Giovanni |
| description | Despite prognosis of glioblastomas is still poor, mounting evidence suggests that more extensive surgical resections are associated with longer life expectancy. However, the surgical indications, at present, are far from uniform and the concept of operability is extremely surgeon-dependant. The results of glioblastoma resection in 104 patients operated on between March 2005 and April 2011 were reviewed with the aim to shed some light on the limits between ‘sins of action’ (operating upon complex tumors causing a permanent severe deficit) and ‘sins of non-action’ (considering inoperable tumors that can be resected with good results). Fifty-five patients (54.4 %) (Group 1) presented with a ‘disputable’ surgical indication because of one or more of the following clinico-radiological aspects: involvement of motor and language areas (39.4 %), deep location (7.7 %), corpus callosum infiltration (13.4 %), or major vessels encasement (8.6 %). Forty-six (42.5 %) patients (Group 2) presented with an ‘indisputable’ surgical indication (readily accessible tumors in non-eloquent areas). Overall mortality was 2.9 %. The mean overall survival was 19.8 months and not significantly different in the two Groups (20.4 Group 2 and 19.5 months for Group 1;
p
= 0.7). Patients with GTR and |
| doi_str_mv | 10.1007/s10072-013-1345-5 |
| format | Article |
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p
= 0.7). Patients with GTR and <72 years had a longer survival (
p
= 0.004 and 0.03, respectively). Seventy patients (69.3 %) showed an uneventful post-operative course, without statistical significance difference between Group 1 and 2. The gross total removal of glioblastoma with many complexities (Group 1) was found to be feasible with acceptable mortality, morbidity and long-term survival rates.</description><identifier>ISSN: 1590-1874</identifier><identifier>EISSN: 1590-3478</identifier><identifier>DOI: 10.1007/s10072-013-1345-5</identifier><identifier>PMID: 23479032</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Aged ; Female ; Glioblastoma - diagnosis ; Glioblastoma - mortality ; Glioblastoma - surgery ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Original Article ; Prognosis ; Psychiatry ; Quality of Life ; Treatment Outcome</subject><ispartof>Neurological sciences, 2013-12, Vol.34 (12), p.2107-2116</ispartof><rights>Springer-Verlag Italia 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-e6edffe94b9ff9356d086051c280fe79331a4e28f5f23ff884129bb96efb40513</citedby><cites>FETCH-LOGICAL-c372t-e6edffe94b9ff9356d086051c280fe79331a4e28f5f23ff884129bb96efb40513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10072-013-1345-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10072-013-1345-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23479032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ferroli, Paolo</creatorcontrib><creatorcontrib>Schiariti, Marco</creatorcontrib><creatorcontrib>Finocchiaro, Gaetano</creatorcontrib><creatorcontrib>Salmaggi, Andrea</creatorcontrib><creatorcontrib>Castiglione, Melina</creatorcontrib><creatorcontrib>Acerbi, Francesco</creatorcontrib><creatorcontrib>Tringali, Giovanni</creatorcontrib><creatorcontrib>Farinotti, Mariangela</creatorcontrib><creatorcontrib>Broggi, Morgan</creatorcontrib><creatorcontrib>Roberto, Cordella</creatorcontrib><creatorcontrib>Maccagnano, Elio</creatorcontrib><creatorcontrib>Broggi, Giovanni</creatorcontrib><title>Operability of glioblastomas: “sins of action” versus “sins of non-action”</title><title>Neurological sciences</title><addtitle>Neurol Sci</addtitle><addtitle>Neurol Sci</addtitle><description>Despite prognosis of glioblastomas is still poor, mounting evidence suggests that more extensive surgical resections are associated with longer life expectancy. However, the surgical indications, at present, are far from uniform and the concept of operability is extremely surgeon-dependant. The results of glioblastoma resection in 104 patients operated on between March 2005 and April 2011 were reviewed with the aim to shed some light on the limits between ‘sins of action’ (operating upon complex tumors causing a permanent severe deficit) and ‘sins of non-action’ (considering inoperable tumors that can be resected with good results). Fifty-five patients (54.4 %) (Group 1) presented with a ‘disputable’ surgical indication because of one or more of the following clinico-radiological aspects: involvement of motor and language areas (39.4 %), deep location (7.7 %), corpus callosum infiltration (13.4 %), or major vessels encasement (8.6 %). Forty-six (42.5 %) patients (Group 2) presented with an ‘indisputable’ surgical indication (readily accessible tumors in non-eloquent areas). Overall mortality was 2.9 %. The mean overall survival was 19.8 months and not significantly different in the two Groups (20.4 Group 2 and 19.5 months for Group 1;
p
= 0.7). Patients with GTR and <72 years had a longer survival (
p
= 0.004 and 0.03, respectively). Seventy patients (69.3 %) showed an uneventful post-operative course, without statistical significance difference between Group 1 and 2. The gross total removal of glioblastoma with many complexities (Group 1) was found to be feasible with acceptable mortality, morbidity and long-term survival rates.</description><subject>Aged</subject><subject>Female</subject><subject>Glioblastoma - diagnosis</subject><subject>Glioblastoma - mortality</subject><subject>Glioblastoma - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Prognosis</subject><subject>Psychiatry</subject><subject>Quality of Life</subject><subject>Treatment Outcome</subject><issn>1590-1874</issn><issn>1590-3478</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kN1KwzAYhoMobk4vwBMZeOJJNF-StolnMvyDwUD0OLRdMjraZiatsLNdiN7crsSUThmCJ_kC7_O9CQ9C50CugZDkxncnxQQYBsYjHB2gIUSSYMYTcbi7g0j4AJ14vySEAAd2jAY0AJIwOkQvs5V2aVaURbMeWzNelIXNytQ3tkr97Xi7-fRF7bskzZvC1tvN1_hDO9_6_ay2Nf7NT9GRSUuvz3ZzhN4e7l8nT3g6e3ye3E1xzhLaYB3ruTFa8kwaI1kUz4mISQQ5FcToRDIGKddUmMhQZowQHKjMMhlrk_HAsRG66ntXzr632jeqKnyuyzKttW29Ah5TEALiKKCXf9ClbV0dftdREDOQggQKeip31nunjVq5okrdWgFRnWrVC1dBuOqEq675YtfcZpWe_278GA4A7QEfonqh3d7T_7Z-A_jwjes</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Ferroli, Paolo</creator><creator>Schiariti, Marco</creator><creator>Finocchiaro, Gaetano</creator><creator>Salmaggi, Andrea</creator><creator>Castiglione, Melina</creator><creator>Acerbi, Francesco</creator><creator>Tringali, Giovanni</creator><creator>Farinotti, Mariangela</creator><creator>Broggi, Morgan</creator><creator>Roberto, Cordella</creator><creator>Maccagnano, Elio</creator><creator>Broggi, Giovanni</creator><general>Springer Milan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Operability of glioblastomas: “sins of action” versus “sins of non-action”</title><author>Ferroli, Paolo ; 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However, the surgical indications, at present, are far from uniform and the concept of operability is extremely surgeon-dependant. The results of glioblastoma resection in 104 patients operated on between March 2005 and April 2011 were reviewed with the aim to shed some light on the limits between ‘sins of action’ (operating upon complex tumors causing a permanent severe deficit) and ‘sins of non-action’ (considering inoperable tumors that can be resected with good results). Fifty-five patients (54.4 %) (Group 1) presented with a ‘disputable’ surgical indication because of one or more of the following clinico-radiological aspects: involvement of motor and language areas (39.4 %), deep location (7.7 %), corpus callosum infiltration (13.4 %), or major vessels encasement (8.6 %). Forty-six (42.5 %) patients (Group 2) presented with an ‘indisputable’ surgical indication (readily accessible tumors in non-eloquent areas). Overall mortality was 2.9 %. The mean overall survival was 19.8 months and not significantly different in the two Groups (20.4 Group 2 and 19.5 months for Group 1;
p
= 0.7). Patients with GTR and <72 years had a longer survival (
p
= 0.004 and 0.03, respectively). Seventy patients (69.3 %) showed an uneventful post-operative course, without statistical significance difference between Group 1 and 2. The gross total removal of glioblastoma with many complexities (Group 1) was found to be feasible with acceptable mortality, morbidity and long-term survival rates.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>23479032</pmid><doi>10.1007/s10072-013-1345-5</doi><tpages>10</tpages></addata></record> |
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| subjects | Aged Female Glioblastoma - diagnosis Glioblastoma - mortality Glioblastoma - surgery Humans Male Medicine Medicine & Public Health Middle Aged Neurology Neuroradiology Neurosciences Neurosurgery Original Article Prognosis Psychiatry Quality of Life Treatment Outcome |
| title | Operability of glioblastomas: “sins of action” versus “sins of non-action” |
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