Abstract
The treatment modalities for gliomas are still questioning and searching. We reviewed
the effect of the extent of surgical resection and reoperation on the length and quality
of survival in 152 consecutive patients who underwent operation for supratentorial
gliomas at GATA Neurosurgery clinic between 1985 to 1995.Seventy-two patients (50%)
had glioblastoma multiforme (GBM), and 48 patients (33%) had anaplastic astrocytoma
(AA). Gross total resection was achieved in 70 cases (49%), subtotal resection was
performed in 60 cases (42%), and biopsy was carried out in 14 cases (9%). Thirty-two
patients were reoperated for recurrency and the median interval between the first
operation and reoperation was 9.5 months in glioblastoma multiforme, and 11.7 months
in anaplastic astrocytoma. The resection groups were compared for age, sex, preoperative
and postoperative Karnofsky rating, tumor location, postoperative radiation therapy,
and chemotherapy, and survival according to multivariate analysis. Preoperative Karnofsky
rating and surgical resection type were the most important factors related to survival
after operation or reoperation. The gross total resection group lived longer than
the subtotal resection group by life table analysis. Median survival of GBM was 76
weeks in gross total resection group, and 33 months in AA group with total resection
(p < 0.001). Preoperative Karnofsky scores had a statistically significant effect
on the quality of life and survival after operation and reoperation in all cases (p
= 0.005). Radical surgery and reoperation also improve quality and length of life
in selective malignant supratentorial gliomas.
Key words
Glial tumor - Radical surgery - Reoperation - Survival
