{"id":"41ea13ab-1b2c-4aa0-a611-54ad7b8b3f2e","slug":"the-value-of-extended-glioblastoma-resection-insights-from-randomized-controlled-trials","title":"The value of extended glioblastoma resection: Insights from randomized controlled trials","authors":["David D. Gonda","Peter Warnke","Nader Sanai","Zack Taich","Ekkehard M. Kasper","Clark C. Chen"],"abstract":"Background: The relationship between the extent of glioblastoma resection (EOR) and clinical benefit remains a critical question in neuro-oncology. While glioblastoma is known to be an aggressively infiltrative disease, it is unclear whether reducing tumor burden enhances the efficacy of subsequent chemo-radiation treatment. Proponents of extended EOR argue that the therapeutic efficacy of chemotherapy is largely dependent on tumor burden, highlighting the need for further investigation. Methods: The article reviews pertinent datasets derived from randomized controlled trials (RCTs) that examine the impact of EOR on clinical outcomes in glioblastoma patients. The analysis includes a prospective randomized study by Vuorinen et al. and five other trials that provide indirect insights into the issue of EOR. The primary endpoints of these studies included overall survival and progression-free survival. Results: The study by Vuorinen et al. found that surgically treated patients had a median survival of 171 days compared to 85 days for biopsy patients (P = 0.035). Other trials indicated improved rates of gross total resection (GTR) with various surgical techniques, but overall survival differences were not consistently observed. Post hoc analyses suggested that patients with greater tumor resection had improved survival, although these findings were limited by statistical flaws. Conclusion: The evidence regarding the impact of EOR on clinical outcomes in glioblastoma is complex and often confounded by methodological limitations. While some studies suggest a benefit of GTR on survival, the overall clinical significance remains uncertain. Further high-quality research is needed to clarify the role of EOR in glioblastoma management. Keywords: glioblastoma, extent of resection, randomized controlled trials, overall survival, progression-free survival, surgical oncology","thumbnailUrl":null,"publishDate":"2013-08-28T00:00:00.000Z","doi":"10.4103/2152-7806.117173","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/05/3767/SNI-4-110.pdf"}