Evidence map›Paper›PMID 36719614›Full record

ArticleJournal of neuro-oncology2023

Surgeon experience in glioblastoma surgery of the elderly-a multicenter, retrospective cohort study.

Johannes P Pöppe, Lukas Machegger, Jürgen Steinbacher, Harald Stefanits, Sophie Eisschiel, Andreas Gruber, Matthias Demetz, Barbara Ladisich, Theo F J Kraus, Serge Weis and 8 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neuro-oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 3 institutions in 3 countries.

Johannes P Pöppe *Department of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria. j.poeppe@salk.at.
Lukas Machegger *Department of Neuroradiology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Jürgen SteinbacherDepartment of Neuroradiology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Harald StefanitsDepartment of Neurosurgery, Neuromed Campus, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
Sophie EisschielDepartment of Neurosurgery, Neuromed Campus, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
Andreas GruberDepartment of Neurosurgery, Neuromed Campus, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
Matthias DemetzDepartment of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Barbara LadisichDepartment of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Theo F J KrausInstitute of Pathology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Serge WeisDivision of Neuropathology, Department of Pathology and Molecular Pathology Kepler University Hospital, Johannes Kepler University, Neuromed Campus, Linz, Austria.
Sabine Spiegl-KreineckerDepartment of Neurosurgery, Neuromed Campus, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
Alexander RomagnaDepartment of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Christoph J GriessenauerDepartment of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Behnam Rezai JahromiDepartment of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Ilari RautalinDepartment of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Mika NiemeläDepartment of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Miikka KorjaDepartment of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Christoph SchwartzDepartment of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Paracelsus Medical University · ATUniversity of Helsinki · FIHelsinki University Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the impact of individual surgeon experience on overall survival (OS), extent of resection (EOR) and surgery-related morbidity in elderly patients with glioblastoma (GBM), we performed a retrospective case-by-case analysis.

methodsGBM patients aged ≥ 65 years who underwent tumor resection at two academic centers were analyzed. The experience of each neurosurgeon was quantified in three ways: (1) total number of previously performed glioma surgeries (lifetime experience); (2) number of surgeries performed in the previous five years (medium-term experience) and (3) in the last two years (short-term experience). Surgeon experience data was correlated with survival (OS) and surrogate parameters for surgical quality (EOR, morbidity).

results198 GBM patients (median age 73.0 years, median preoperative KPS 80, IDH-wildtype status 96.5%) were included. Median OS was 10.0 months (95% CI 8.0-12.0); median EOR was 89.4%. Surgery-related morbidity affected 19.7% patients. No correlations of lifetime surgeon experience with OS (P = .693), EOR (P = .693), and surgery-related morbidity (P = .435) were identified. Adjuvant therapy was associated with improved OS (P < .001); patients with surgery-related morbidity were less likely to receive adjuvant treatment (P = .002). In multivariable testing, adjuvant therapy (P < .001; HR = 0.064, 95%CI 0.028-0.144) remained the only significant predictor for improved OS.

conclusionLess experienced neurosurgeons achieve similar surgical results and outcome in elderly GBM patients within the setting of academic teaching hospitals. Adjuvant treatment and avoidance of surgery-related morbidity are crucial for generating a treatment benefit for this cohort.

Indexed as

Brain NeoplasmsGlioblastomaAgedHospitals, TeachingHumansNeurosurgeonsNeurosurgical ProceduresRetrospective StudiesElderlyExtent of resectionGlioblastomaMorbidityOutcomeSurgeon experience

Identifiers

PMID36719614
PMCPMC9992256
OpenAlexW4318617217

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.