ArticleJournal of neuro-oncology2024
Repeat surgery of recurrent glioma for molecularly informed treatment in the age of precision oncology: A risk-benefit analysis.
Article in Journal of neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Surgical treatment of recurrent glioblastoma: a multicenter perspective from the Italian society of neurosurgery (SINchNeurosurgical review · 2026Pooled it
- Current trends in reoperation for recurrent glioblastoma: a meta-analysis (2007-2023).Journal of neuro-oncology · 2025Pooled it
- Gross Total Resection and Recurrence-Free Survival in Diffuse Gliomas: A Single-Center Cohort Study from Eastern Europe.Clinics and practice · 2026Article
- Prognostic relevance of resection at first recurrence in isocitrate dehydrogenase mutant lower-grade glioma: results from a retrospective, single-center, volumetric analysis.Journal of neuro-oncology · 2026Observational
- Repeat resection for recurrent glioblastoma - does timing matter?Journal of neuro-oncology · 2026Article
- MGMT promoter methylation modulates the effect of residual tumor on survival after re-resection of recurrent glioblastoma.Acta neuropathologica communications · 2026Article
- The utility of intraoperative magnetic resonance imaging in recurrent glioblastoma surgery: A volumetric analysis.Brain & spine · 2026Article
- Review
- Oligodendroglioma of the Hippocampus: A Case Report and Systematic Review on Therapeutic Approaches of Oligodendroglioma After WHO 2021 Classification.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Functional and oncological outcomes following more than three consecutive surgical resections for multiple relapses of initially grade 2 IDH-mutated gliomas.Acta neurochirurgica · 2024Article
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSurgery for recurrent glioma provides cytoreduction and tissue for molecularly informed treatment. With mostly heavily pretreated patients involved, it is unclear whether the benefits of repeat surgery outweigh its potential risks.
methodsPatients receiving surgery for recurrent glioma WHO grade 2-4 with the goal of tissue sampling for targeted therapies were analyzed retrospectively. Complication rates (surgical, neurological) were compared to our institutional glioma surgery cohort. Tissue molecular diagnostic yield, targeted therapies and post-surgical survival rates were analyzed.
resultsBetween 2017 and 2022, tumor board recommendation for targeted therapy through molecular diagnostics was made for 180 patients. Of these, 70 patients (38%) underwent repeat surgery. IDH-wildtype glioblastoma was diagnosed in 48 patients (69%), followed by IDH-mutant astrocytoma (n = 13; 19%) and oligodendroglioma (n = 9; 13%). Gross total resection (GTR) was achieved in 50 patients (71%). Tissue was processed for next-generation sequencing in 64 cases (91%), and for DNA methylation analysis in 58 cases (83%), while immunohistochemistry for mTOR phosphorylation was performed in 24 cases (34%). Targeted therapy was recommended in 35 (50%) and commenced in 21 (30%) cases. Postoperatively, 7 patients (11%) required revision surgery, compared to 7% (p = 0.519) and 6% (p = 0.359) of our reference cohorts of patients undergoing first and second craniotomy, respectively. Non-resolving neurological deterioration was documented in 6 cases (10% vs. 8%, p = 0.612, after first and 4%, p = 0.519, after second craniotomy). Median survival after repeat surgery was 399 days in all patients and 348 days in GBM patients after repeat GTR.
conclusionSurgery for recurrent glioma provides relevant molecular diagnostic information with a direct consequence for targeted therapy under a reasonable risk of postoperative complications. With satisfactory postoperative survival it can therefore complement a multi-modal glioma therapy approach.
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