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Abstract
Aim. To evaluate the extent of resection and its impact on prognosis in patients with IDH wild-type glioblastoma.
Materials and methods. The treatment outcomes of 63 patients with IDH-wildtype grade 4 glioblastoma were analyzed. Radicality of resection was staged according to the Response Assessment in Neuro-oncology (RANO) criteria for assessing the extent of resection in glioblastoma (2023). Pre- and post-operative tumor volumes were measured by semi-automated or manual segmentation. Statistical analysis was performed using StatTech v. 4.7.0 (developer - Stattech LLC, Russia).
Results. When Cox regression was used to assess the relationship between overall survival and the pre- and post-operative volumes of the contrast-enhancing part of the glioblastoma and the FLAIR zone, the only predictor affecting survival was the post-operative volume of the contrast-enhancing part - for every 1 cm3 increase in the remaining volume of the contrast-enhancing part, the risk of death increased by 1.046 times (p = 0.018). When evaluating the relationship between overall survival and resection class according to the RANO criteria (2023), the differences in overall survival were statistically significant using the likelihood ratio test (p = 0.012). The risk of death increased 3.356-fold with resection class 3B.
Conclusion. Complete removal of the contrast-enhancing part of the glioblastoma is an important goal of surgical treatment, but the same cannot be said for the usefulness of FLAIR zone resection. The RANO criteria clearly demonstrate their value in assessing the extent of resection in patients with IDH wild-type glioblastoma.
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