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The role of cytoreductive surgery in the management of progressive glioblastoma

A systematic review and evidence-based clinical practice guideline

  • TOPIC REVIEW & CLINICAL GUIDELINES
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Question

Should patients with previously diagnosed malignant glioma who are suspected of experiencing progression of the neoplasm process undergo repeat open surgical resection?

Target population

These recommendations apply to adults with previously diagnosed malignant glioma who are suspected of experiencing progression of the neoplastic process and are amenable to surgical resection.

Recommendations

Level II

Repeat cytoreductive surgery is recommended in symptomatic patients with locally recurrent or progressive malignant glioma. The median survival in these patient diagnosed with glioblastoma is expected to range from 6 to 17 months following a second procedure.

It is recommended that the following preoperative factors be considered when evaluating a patient for repeat operation: location of recurrence in eloquent/critical brain regions, Karnofsky Performance Status and tumor volume.

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Acknowledgments

We would like to acknowledge the AANS/CNS Joint Guidelines Committee for their review, comments and suggestions, the contributions of Laura Mitchell, CNS Guidelines Manager for organizational assistance, Maxine Brown for searching for and retrieving literature and Amy Allison for reference library consultations. We would also like to acknowledge the following individual JGC members for their contributions throughout the review process: Sepideh Amin-Hanjani, MD, FAANS, FACS, FAHA, Martina Stippler, MD, Alexander Khalessi, MD, Isabelle Germano, MD, Sean D. Christie, MD, FRCS (C), Gregory J. Zipfel, MD, Zachary Litvack, MD, MCR, Ann Marie Flannery, MD, Patricia B Raksin, MD, Joshua M. Rosenow, MD, FACS, Steven Casha, MD, PhD, Julie G. Pilitsis, MD, PhD, Gabriel Zada, MD, Adair Prall, Krystal Tomei, MD, Gregory W Hawryluk, MD.

Conflict of interest (COI)

Task Force members report potential COIs prior to beginning work on the guideline and at the time of publication. COI disclosures are reviewed by the Task Force Chair and taken into consideration when determining writing assignments. Resolution of potential COIs included Task Force members were assigned to chapters that did not involve or in any way relate to the potential COIs disclosed.

Disclaimer of liability

The information in these guidelines reflects the current state of knowledge at the time of completion. The presentations are designed to provide an accurate review of the subject matter covered. These guidelines are disseminated with the understanding that the recommendations by the authors and consultants who have collaborated in their development are not meant to replace the individualized care and treatment advice from a patient’s physician(s). If medical advice or assistance is required, the services of a physician should be sought. The proposals contained in these guidelines may not be suitable for use in all circumstances. The choice to implement any particular recommendation contained in these guidelines must be made by a managing physician in light of the situation in each particular patient and on the basis of existing resources.

Funding source

These guidelines were funded exclusively by the CNS and Tumor Section of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons whom received no funding from outside commercial sources to support the development of this document unless otherwise stated in this section.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Iowa Spine and Brain Institute, Waterloo, IA, USA

    Timothy Charles Ryken

  2. Department of Neurosurgery, University of Iowa, Iowa City, IA, USA

    Timothy Charles Ryken

  3. Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA

    Steven N. Kalkanis

  4. Department of Radiation Oncology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA

    John M. Buatti

  5. Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA

    Jeffrey J. Olson

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  1. Timothy Charles Ryken
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Correspondence to Timothy Charles Ryken.

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Ryken, T.C., Kalkanis, S.N., Buatti, J.M. et al. The role of cytoreductive surgery in the management of progressive glioblastoma. J Neurooncol 118, 479–488 (2014). https://doi.org/10.1007/s11060-013-1336-7

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  • DOI: https://doi.org/10.1007/s11060-013-1336-7

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