ArticleNeuro-oncology advances
Value-based assessment of repeat surgery for recurrent glioma: A real-world quality-adjusted survival analysis.
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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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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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.
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Authors and funding
9 authors.
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Abstract
Background: Reoperation for recurrent glioma is widely practiced, yet clinical decision-making remains challenging due to substantial trade-offs between survival gain and postoperative functional burden. High-quality real-world evidence integrating survival and quality-of-life outcomes to inform reoperation decisions remains limited. Methods: We conducted a retrospective real-world cohort study of 1304 patients with recurrent glioma treated between 2010 and 2018. Propensity score matching was applied to balance baseline characteristics. Survival outcomes, quality-adjusted life years (QALYs), functional status, and prognostic factors associated with reoperation benefit were evaluated. Results: In the 1:1 propensity-matched cohort (140 reoperation vs 140 non-reoperation), reoperation was associated with a mean gain of 9.6 months in quality-adjusted life years (QALYs) and a 521-day longer overall survival. Postoperative functional status showed short-term improvement. In the glioblastoma subgroup, reoperation was associated with a numerical gain of 3.5 QALY months, although the confidence interval crossed zero, alongside a 218-day gain in overall survival. Predictive models based on preoperative characteristics demonstrated good discrimination in identifying patients likely to derive survival benefit beyond 6 months. Conclusion: This study provides real-world evidence that carefully selected patients with recurrent glioma may derive quality-adjusted survival benefits from reoperation, thereby supporting individualized surgical decision-making. These findings have implications for value-based surgical decision-making in recurrent glioma, particularly in healthcare systems where balancing survival benefit against functional outcomes and resource use is increasingly important.
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