Luasnya reseksi terkait dengan kemungkinan bertahan hidup dengan glioblastoma
Date:
June 16, 2016
Source:
The JAMA Network Journals
Summary:
Luasnya reseksi pada pasien dengan glioblastoma , tumor otak yang agresif dan sering fatal , dikaitkan dengan kemungkinan kelangsungan hidup dan perkembangan penyakit , menurut sebuah studi baru .
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Luasnya reseksi pada pasien dengan glioblastoma , tumor otak yang agresif dan sering fatal , dikaitkan dengan kemungkinan kelangsungan hidup dan perkembangan penyakit , menurut sebuah studi baru yang diterbitkan secara online oleh JAMA Oncology .
Glioblastoma multiforme ( GBM ) adalah tumor otak ganas yang paling umum pada orang dewasa . Kombinasi yang optimal dari medis terapi , bedah dan radiasi belum ditetapkan . Komponen bedah dapat berkisar dari biopsi invasif minimal untuk kraniotomi ( pembukaan tengkorak ) dengan tujuan reseksi total bruto ( GTR ) . Tapi tidak setiap pasien menerima reseksi agresif . Anatomi otak dan kekhawatiran tentang cedera struktur di sekitarnya penting dengan penurunan nilai dan menyebabkan berarti tujuan GTR bisa sulit untuk dicapai.
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Extent of
resection associated with likelihood of survival in glioblastoma
Date:
June 16, 2016
Source:
The JAMA Network Journals
Summary:
The extent of
resection in patients with glioblastoma, an aggressive and often fatal brain
tumor, was associated with the likelihood of survival and disease progression,
according to a new study.
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The extent of resection in patients
with glioblastoma, an aggressive and often fatal brain tumor, was associated
with the likelihood of survival and disease progression, according to a new
study published online by JAMA Oncology.
Glioblastoma multiforme
(GBM) is the most common malignant brain tumor in adults. The optimal
combination of medical, surgical and radiation therapy has not been defined.
The surgical component can range from minimally invasive biopsy to a craniotomy
(opening of the skull) with the goal of gross total resection (GTR). But not
every patient receives an aggressive resection. The anatomy of the brain and
concern about injury to important surrounding structures with resulting
impairment mean the goal of GTR can be difficult to attain.
Michael Glantz, M.D., of
the Penn State Milton S. Hershey Medical Center, Hershey, Penn., and coauthors
compared GTR with subtotal resection (STR) or biopsy with overall and
progression-free survival in a meta-analysis of 37 studies (41,117 patients).
The study reports a lower
relative risk of death at one and two years. The authors suggest GTR may
increase the likelihood of 1-year survival compared with STR by about 61
percent and may increase the likelihood of two-year survival by about 19
percent. The one-year risk for mortality for STR compared with biopsy was
reduced and the risk for mortality was less for any resection compared with
biopsy at years one and two, according to the results.
Overall, a reduction in
mortality was associated with an increasing extent of resection. GTR also was
associated with decreased disease progression over one year, according to the
results.
The authors note the
results should be interpreted in the context of important caveats, including
that GTR and STR groups differed on a number of factors and that the extent of
tumor resection was defined by authors in studies, often imprecisely.
"Although the
available studies are retrospective and mostly carry a high risk for bias and
confounding, an overwhelming consistency of the evidence (including three class
2 studies) supports the superiority of GTR over STR and biopsy. ... Therefore,
when clinically feasible, the body of literature favors GTR in all patients
with newly diagnosed GBM," the authors conclude.
Story Source:
The above post is reprinted
from materials provided
by The JAMA Network Journals. Note:
Materials may be edited for content and length.
Journal Reference:
1. Timothy J. Brown,
Matthew C. Brennan, Michael Li, Ephraim W. Church, Nicholas J. Brandmeir, Kevin
L. Rakszawski, Akshal S. Patel, Elias B. Rizk, Dima Suki, Raymond Sawaya,
Michael Glantz. Association of the Extent of
Resection With Survival in Glioblastoma. JAMA
Oncology, 2016; DOI: 10.1001/jamaoncol.2016.1373