Biomedical papers, 2015 (vol. 159), issue 1

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(1):150-155 | 10.5507/bp.2013.052

Resection versus biopsy of glioblastomas in eloquent brain areas

Lumir Hrabaleka, Ondrej Kalitaa, Miroslav Vaverkaa ,Marian Hajduchb, Miloslava Zlevorovac, Jiri Ehrmann Jrd, Eva Cechakovag, Milan Adamuse, Vlastimil Novaka, Katerina Langovaf
a Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
b Laboratory of Experimental Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc
c Department of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc
d Department of Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc
e Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc
f Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc
g Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc

Aim: The aim of this study was to compare resection and biopsy of glioblastoma (GBM) in eloquent brain areas (EBA).

Methods: This was a prospective evaluation of 38 patients with GBM in EBA. 22 were treated by surgical resection and 16 by biopsy. Preoperative KPS, neurological status and size of lesion on MRI were assessed. One week and three months postoperatively KPS, neurological status and Performance Status (PS) WHO were evaluated. Extent of resection (EOR) and overall survival (OS) were described. Overall mean age of the patients was 64.3 years, the mean lesion size in the resection group was 47.7 mm and in the biopsy group 51.0 mm.

Results: Worsening or development of permanent neurological deficits 3 months after surgery were significantly lower in the resection group (23%), than the biopsy group (94%). In the resection group the median pre and postoperative KPS three months after surgery was 80.0. In the biopsy group the median pre and postoperative KPS was 68.1 one week after the procedure. In the resection group, 3 months after surgery, the median PS was 1, in the biopsy group one week after surgery the median PS was 2. The difference was statistically insignificant. The mean OS after resection was 12.2 months, and after biopsy 3.5 months. The difference was highly statistically significant. The mean EOR was 90%.

Conclusion: This is the first prospective study, to our knowledge, that compares the results of resection and biopsy of primary GBM in EBA. For patients in good clinical condition with tumors in or near EBA, recommended is as radical resection of GBM as possible.

Keywords: glioblastoma multiforme, eloquent brain area, resection, biopsy

Received: March 17, 2013; Accepted: July 1, 2013; Prepublished online: July 29, 2013; Published: March 9, 2015


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