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Patterns of recurrence according to the extent of resection in patients with IDH-wild-type glioblastoma: a retrospective study

 Jihwan Yoo  ;  Seon-Jin Yoon  ;  Kyung Hwan Kim  ;  In-Ho Jung  ;  Seung Hoon Lim  ;  Woohyun Kim  ;  Hong In Yoon  ;  Se Hoon Kim  ;  Kyoung Su Sung  ;  Tae Hoon Roh  ;  Ju Hyung Moon  ;  Hun Ho Park  ;  Eui Hyun Kim  ;  Chang-Ok Suh  ;  Seok-Gu Kang  ;  Jong Hee Chang 
 JOURNAL OF NEUROSURGERY, Vol.137(2) : 533-543, 2022-08 
Journal Title
Issue Date
extent of resection ; glioblastoma ; oncology ; pattern of recurrence ; subventricular zone ; supratotal resection
Objective: In glioblastoma (GBM) patients, controlling the microenvironment around the tumor using various treatment modalities, including surgical intervention, is essential in determining the outcome of treatment. This study was conducted to elucidate whether recurrence patterns differ according to the extent of resection (EOR) and whether this difference affects prognosis.

Methods: This single-center study included 358 eligible patients with histologically confirmed isocitrate dehydrogenase (IDH)-wild-type GBM from November 1, 2005, to December 31, 2018. Patients were assigned to one of three separate groups according to EOR: supratotal resection (SupTR), gross-total resection (GTR), and subtotal resection (STR) groups. The patterns of recurrence were classified as local, marginal, and distant based on the range of radiation. The relationship between EOR and recurrence pattern was statistically analyzed.

Results: Observed tumor recurrence rates for each group were as follows: SupTR group, 63.4%; GTR group, 75.3%; and STR group, 80.5% (p = 0.072). Statistically significant differences in patterns of recurrences among groups were observed with respect to local recurrence (SupTR, 57.7%; GTR, 76.0%; STR, 82.8%; p = 0.036) and distant recurrence (SupTR, 50.0%; GTR, 30.1%; STR, 23.2%; p = 0.028). Marginal recurrence showed no statistical difference between groups. Both overall survival and progression-free survival were significantly increased in the SupTR group compared with the STR and GTR groups (p < 0.0001).

Conclusions: In this study, the authors investigated the association between EOR and patterns of recurrence in patients with IDH-wild-type GBM. The findings not only show that recurrence patterns differ according to EOR but also provide clinical evidence supporting the hypothesized mechanism by which distant recurrence occurs.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Kim, Kyung Hwan(김경환)
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Woohyun(김우현) ORCID logo https://orcid.org/0000-0002-2936-3740
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Moon, Ju Hyung(문주형)
Park, Hun Ho(박현호) ORCID logo https://orcid.org/0000-0002-2526-9693
Yoo, Jihwan(유지환)
Yoon, Seon Jin(윤선진) ORCID logo https://orcid.org/0000-0002-3255-5081
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Jung, In-Ho(정인호)
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