Impact of extent of resection on outcome from glioblastoma using the RANO resect group classification system: a retrospective, population-based cohort study
Bjorland, Line; Mahesparan, Rupavathana; Fluge, Øystein; Gilje, Bjørnar; Kurz, Kathinka Dæhli; Farbu, Elisabeth
Peer reviewed, Journal article
Published version
Permanent lenke
https://hdl.handle.net/11250/3125756Utgivelsesdato
2023Metadata
Vis full innførselSamlinger
Originalversjon
Bjorland, L. S., Mahesparan, R., Fluge, Ø., Gilje, B., Dæhli Kurz, K., & Farbu, E. (2023). Impact of extent of resection on outcome from glioblastoma using the RANO resect group classification system: a retrospective, population-based cohort study. Neuro-Oncology Advances, 5(1), vdad126. 10.1093/noajnl/vdad126Sammendrag
Background
Extent of resection (EOR) is associated with survival in glioblastoma. A standardized classification for EOR was lacking until a system was recently proposed by the response assessment in neuro-oncology (RANO) resect group. We aimed to assess EOR in an unselected glioblastoma cohort and use this classification system to evaluate the impact on survival in a real-world setting.
Methods
We retrospectively identified all patients with histologically confirmed glioblastoma in Western Norway between 1.1.2007 and 31.12.2014. Volumetric analyses were performed using a semi-automated method. EOR was categorized according to the recent classification system. Kaplan–Meier method and Cox proportional hazard ratios were applied for survival analyses.
Results
Among 235 included patients, biopsy (EOR class 4) was performed in 50 patients (21.3%), submaximal contrast enhancement (CE) resection (EOR class 3) in 66 patients (28.1%), and maximal CE resection (EOR class 2) in 119 patients (50.6%). Median survival was 6.2 months, 9.2 months, and 14.9 months, respectively. Within EOR class 2, 80 patients underwent complete CE resection (EOR class 2A) and had a median survival of 20.0 months, while 39 patients had a near-total CE resection, with ≤1 cm3 CE residual volume (EOR class 2B), and a median survival of 11.1 months, P < 0.001. The 2-year survival rate in EOR class 2A was 40.0%, compared to 7.7% in EOR class 2B.
Conclusions
RANO resect group classification for the extent of resection reflected outcome from glioblastoma in a real-world setting. There was significantly superior survival after complete CE resection compared to near-total resection.