ArticleNeuro-oncology advances
Neurosurgeons' perspective on surgical treatment of glioblastoma: Practices, beliefs and willingness to randomize in surgical trials.
Article in Neuro-oncology advances. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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17 authors.
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Abstract
Background: The optimal extent of resection for glioblastoma remains debated, with high-level evidence from randomized controlled trials (RCTs) notably scarce. We aimed to evaluate international surgical practices, perceived quality of evidence, and feasibility of future RCTs through an international survey of neurosurgeons. Methods: An international survey was distributed via European Organization for Research and Treatment of Cancer (EORTC), European Association of Neurosurgical Societies (EANS), Congress of Neurological Surgeons (CNS), and national societies. We used descriptive statistics to summarize surgical practices and univariate analysis and multivariate regression to identify demographic or institutional factors associated with clinical decision-making. Results: Responses were received from 328 neurosurgeons across 38 countries. Participation was predominantly from Europe (81.1%), with 12.2% from North America. Most participants (82.9%) practiced in academic centers. While 60.4% identified supramarginal resection (SMR) as the optimal surgical goal, 37.8% aim for complete resection of enhancing tumor (CRET). Overall, 90.2% viewed the evidence for CRET as strong, compared to 63.1% for SMR. Despite these views, 72.6% expressed willingness to randomize patients between CRET and SMR, while 49.4% would be willing to randomize between partial resection and biopsy, if CRET is not feasible. Despite differences in individual practice, willingness to participate in RCTs remained consistent across geographic regions. The incomplete overlap between case-based decisions and general willingness to randomize highlights the importance of case-specific nuances. A paradox was observed where perceived weak evidence correlated with lower willingness to randomize( Conclusion: There is substantial global willingness among neurosurgeons to participate in surgical RCTs for glioblastoma. These findings provide a foundation for designing future international trials to resolve long-standing controversies regarding optimal surgical strategy for glioblastoma.
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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.