Evidence map›Paper›PMID 40314867›Full record

SynthesisJournal of neuro-oncology2025

Current trends in reoperation for recurrent glioblastoma: a meta-analysis (2007-2023).

Pavel S Pichardo-Rojas, Fabricio Garcia-Torrico, César B Espinosa-Cantú, Francisco A Rodriguez-Elvir, Andrea C Beltran-De la Fuente, Myriam S Hernandez-Garcia, James S Trippett, Alexis Morell, Ashish H Shah, Ricardo J Komotar and 1 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Pavel S Pichardo-RojasThe Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, USA.
Fabricio Garcia-TorricoUniversidad Mayor de San Andrés, La Paz, Bolivia.
César B Espinosa-CantúUniversidad Autónoma de Nuevo León, Monterrey, México.
Francisco A Rodriguez-ElvirSanta Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil.
Andrea C Beltran-De la FuenteUniversidad México Americana Del Norte, Tamaulipas, México.
Myriam S Hernandez-GarciaFacultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlanepantla, México.
James S TrippettThe Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, USA.
Alexis MorellDepartment of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ashish H ShahDepartment of Neurological Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
Ricardo J KomotarVivian L. Smith Department of Neurosurgery and Center for Precision Health, McGovern Medical School, The University of Texas Health Science Center at Houston, 6400 Fannin Street Suite # 2800, Houston, TX, 77030, USA.
Yoshua EsquenaziThe Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, USA. Yoshua.EsquenaziLevy@uth.tmc.edu.ORCID http://orcid.org/0000-0002-9757-1453

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDespite conflicting evidence, reoperation for recurrent glioblastoma (rGBM) achieving complete resection of enhancing-tumor (CRET) may offer benefits over partial resection or salvage therapy alone. However, pooled analyses remain limited.

methodsA systematic search identified rGBM studies comparing reoperation and non-reoperation, including chemotherapy with/without radiotherapy, radiation-based therapies (RBT), and best supportive care (BSC).

resultsThirty-six studies, comprising 10,738 patients, were included, with 2,806 undergoing reoperation. Nine propensity-score-matched studies and one clinical trial were identified. Mean overall survival (OS) favored reoperation (19.66 months) over chemotherapy with/without radiotherapy (12.56 months, p < 0.00001) and BSC (4.04 months, p < 0.00001), but not over chemotherapy alone (14.60 months) or RBT (14.26 months)(p > 0.05). Multivariate OS favored reoperation over chemotherapy with/without radiation(HR = 0.62,95%CI:0.50-0.76,p < 0.00001), but not to stereotactic radiosurgery (SRS) (HR = 0.52,95%CI:0.25-1.08,p = 0.08) or chemotherapy alone (HR = 0.80,95%CI:0.63-1.00,p = 0.05). Progression-free survival after recurrence (PFS2) was only compared between reoperation and chemotherapy with/without radiotherapy, favoring reoperation (8.36 vs. 4.97 months, p < 0.00001). Multivariate analysis also favored reoperation (HR = 0.56, 95% CI:0.41-0.76,p = 0.0002).The mean post-recurrence survival (PRS) was 12.18 months in the reoperation group, 9.19 months in the chemotherapy with/without radiotherapy, and 9.64 months in SRS. Multivariate PRS favored reoperation over chemotherapy with/without radiotherapy (HR = 0.78, 95%CI: 0.62-0.98,p = 0.04). CRET with < 1 cm

conclusionThe role of reoperation in rGBM remains uncertain. While it may improve survival in selected cases, limited high-quality data hinder definitive conclusions. Achieving CRET may correlate with improved PRS over partial resection. Further prospective trials are necessary to guide optimal management of rGBM.

Indexed as

Brain NeoplasmsGlioblastomaNeoplasm Recurrence, LocalReoperationHumansComplicationsGlioblastomaOverall SurvivalPost-Recurrent SurvivalProgression-Free Survival-2Reoperation

Identifiers

What OpenQuestion holds

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Registered trials

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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.