ArticleJournal of neuro-oncology2025
Impact of maximal and supramaximal resections on postoperative diffusion-weighted imaging changes and clinical outcomes in IDH-wildtype glioblastoma.
Article 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.
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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.
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Who cites it
2 citing papers in PubMed.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe standard of care for glioblastoma (GBM) involves maximal-safe resection. We evaluated the relationship between postoperative diffusion-weighted imaging (DWI) changes, extent of resection (EOR), and clinical outcomes in patients with GBM.
methodsWe retrospectively analyzed 323 patients with newly diagnosed IDH-wildtype GBM who underwent surgical resection between 2005 and 2023. EOR was categorized according to RANO-resect categories into supramaximal (class 1), complete (class 2 A), near-total (class 2B), and submaximal (class 3) groups. We assessed postoperative DWI and ADC maps 24-72 h following surgery.
resultsPostoperative DWI restriction was detected in 161 patients and was positively correlated with preoperative tumor volume (r = 0.196,p = 0.026). The most common DWI restriction patterns included sector-shaped (59%), rim-shaped (34%), mixed (6%), and remote (1%). DWI restriction incidence was comparable across resection classes: 37.5% in supramaximal resection, 51% in complete resection, 50.9% in near-total resection, and 50.7% in submaximal resection (p = 0.663). Patients who underwent maximal/supramaximal (class 1 and 2) resection had a significantly longer median OS (20 versus 14 months, p = 0.013;multivariate HR = 0.74[95%CI = 0.58-0.96], p = 0.023) and achieved a favorable Karnofsky Performance Score (KPS) ≥ 70 (87.5% vs. 73.0%) over submaximal (class 3) resection (p = 0.001). New neurological deficits were rare in both the maximal/supramaximal (class 1 and 2) (1.7%) and submaximal (class 3) (4.9%) groups (p = 0.278). DWI restriction did not impact survival (p = 0.499).
conclusionMaximal and supramaximal resections in IDH-wildtype GBM improve survival and function, with low morbidity despite DWI changes. Further research should assess the long-term impact of DWI changes on cognition and quality of life.
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