Trial reportOncotarget2016
Supra-complete surgery via dual intraoperative visualization approach (DiVA) prolongs patient survival in glioblastoma.
Trial report in Oncotarget, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07162324 (Prognostic Factors, Surgical Management and Survival of Glioblastoma Patients), which is not on this map. Cited by 53 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prognostic Factors, Surgical Management and Survival of Glioblastoma Patients: a Multicenter Prospective Study
Who cites it
53 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- EANS-EANO guidelines on the extent of resection in gliomas.Neuro-oncology · 2026Guideline
- Neuronavigation in glioma resection: current applications, challenges, and clinical outcomes.Frontiers in surgery · 2024Pooled it
- Supramaximal versus gross total resection in Glioblastoma, IDH wild-type and Astrocytoma, IDH-mutant, grade 4, effect on overall and progression free survival: systematic review and meta-analysis.Journal of neuro-oncology · 2023Pooled it
- Intraoperative 5-ALA fluorescence-guided resection of high-grade glioma leads to greater extent of resection with better outcomes: a systematic review.Journal of neuro-oncology · 2022Pooled it
- Pooled it
- Cytoreductive surgery in the management of newly diagnosed glioblastoma in adults: a systematic review and evidence-based clinical practice guideline update.Journal of neuro-oncology · 2020Pooled it
- A systematic review and meta-analysis of supratotal versus gross total resection for glioblastoma.Journal of neuro-oncology · 2020Pooled it
- Supratotal resection in glioma: a systematic review.Neuro-oncology · 2019Pooled it
- Survival Outcomes Among Patients With High-Grade Glioma Treated With 5-Aminolevulinic Acid-Guided Surgery: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2019Pooled it
- Contemporary surgical strategies for resection of intracranial gliomas.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Review
- Supramaximal resection in gliomas: a narrative review of surgical techniques, clinical outcomes, and ethical considerations.Annals of medicine and surgery (2012) · 2026Review
- Review
- Integration of 5-ALA fluorescence and intraoperative MRI in awake craniotomy for glioma resection: a six-year retrospective analysis.Neurosurgical review · 2025Article
- Malignant Cells Beyond the Tumor Core: The Non-Negligible Factor to Overcome the Refractory of Glioblastoma.CNS neuroscience & therapeutics · 2025Review
- Pushing the boundaries of neurosurgical oncology: evaluating the superiority of supratotal resection over gross total resection in intraoperative MRI-guided glioma surgery.Neurosurgical review · 2025Article
- The Role of Lobectomy in Glioblastoma Management.Advances and technical standards in neurosurgery · 2025Review
- The role of Lobectomy in Glioblastoma management: A Retrospective series.Brain & spine · 2025Article
- The Alcatraz-Strategy: a roadmap to break the connectivity barrier in malignant brain tumours.Molecular oncology · 2024Review
- Understanding treatment preferences and cognitive outcomes in patients with gliomas.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- The role of lobectomy in glioblastoma management: A systematic review and meta-analysis.Brain & spine · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Safe and complete resection represents the first step in the treatment of glioblastomas and is mandatory in increasing the effectiveness of adjuvant therapy to prolong overall survival. With gross total resection currently limited in extent to MRI contrast enhancing areas, the extent to which supra-complete resection beyond obvious contrast enhancement could have impact on overall survival remains unclear. DiVA (dual intraoperative visualization approach) redefines gross total resection as currently accepted by enabling for the first time supra-complete surgery without compromising patient safety. This approach exploits the advantages of two already accepted surgical techniques combining intraoperative MRI with integrated functional neuronavigation and 5-ALA by integrating them into a single surgical approach. We investigated whether this technique has impact on overall outcome in GBM patients. 105 patients with GBM were included. We achieved complete resection with intraoperative MRI alone according to current best-practice in glioma surgery in 75 patients. 30 patients received surgery with supra-complete resection. The control arm showed a median life expectancy of 14 months, reflecting current standards-of-care and outcome. In contrast, patients receiving supra-complete surgery displayed significant increase in median survival time to 18.5 months with overall survival time correlating directly with extent of supra-complete resection. This extension of overall survival did not come at the cost of neurological deterioration. We show for the first time that supra-complete glioma surgery leads to significant prolongation of overall survival time in GBM patients.
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