TY - JOUR
T1 - Operability of glioblastomas
T2 - "sins of action" versus "sins of non-action"
AU - Ferroli, Paolo
AU - Schiariti, Marco
AU - Finocchiaro, Gaetano
AU - Salmaggi, Andrea
AU - Castiglione, Melina
AU - Acerbi, Francesco
AU - Tringali, Giovanni
AU - Farinotti, Mariangela
AU - Broggi, Morgan
AU - Roberto, Cordella
AU - Maccagnano, Elio
AU - Broggi, Giovanni
PY - 2013/12
Y1 - 2013/12
N2 - 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
AB - 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
KW - Glioblastoma
KW - Neurosurgery
KW - Operability
KW - Quality of life
KW - Survival
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U2 - 10.1007/s10072-013-1345-5
DO - 10.1007/s10072-013-1345-5
M3 - Article
C2 - 23479032
AN - SCOPUS:84890558696
VL - 34
SP - 2107
EP - 2116
JO - Neurological Sciences
JF - Neurological Sciences
SN - 1590-1874
IS - 12
ER -