P17.44 * THE EFFECT OF A SURGERY RATIONALE ON LIFE EXPECTANCY WITHIN PRIMARY GLIOBLASTOMA MULTIFORME PATIENTS: RESECTION COMPARE TO SOLE BIOPSY. SIX AND HALF YEAR REGULAR FOLLOW-UP EXPERIENCES OF ONE ONCO-CENTREDATABASE OF INTRACRANIAL TUMOURS (DOIT) OF CZECH REPUBLIC
Authors: O. Kalita, M. Vaverka, L. Hrabalek, M. Zlevorova, E. Cechakova, R. Trojanec, M. Kneblova, None Mgr., L. Tuckova, J. Muzik
Journal: Neuro-Oncology (2014)

INTRODUCTION: From a publishing of Stupp study conclusion, we have added chemotherapy to surgery and radiotherapy into GBM standard therapy. Unfortunately, an idea of growing role of the GBM oncotherapy (assumption of the final GBM solution) and decreasing part of the GBM resection (only biopsy will remain) fails. GBM cells behave this way for very intricate biological and genetic GBM matter and for its adverse, but unavoidable changing caused by the selective pressure of oncologic procedures. A primary aim of this paper is life expectancy appreciation of GBM patients with resection and sole biopsy, both subsequently treated by Stupp protocol. METHOD: From 2006 July 1 to 2012 December 31 we followed prospectively patients with primary GBM treated in our hospital. Information about surgeries, patient clinical condition, imaging, and results of histological, imunohistochemical, molecular genetics and cytogenetical investigations were gathered. Biopsy was recommended for unresectable tumours, also for patients with KS <60, and PS WHO KS <2 . The rest of patients were managed to resection. The percent of the surgical radicality more than 70 was confirmed by early MRI. RESULTS: During 66 months we have gathered 131 patients with primary GBM. No patient without early postrection MRI was included. No patient with the percent resection less than 70% was included. Forty-two patients (32.1%) had only biopsy and 89 patients (67.9%) had surgery. An overage age of patient with biopsy was 68 years, and with surgery was 63 years. Oncotherapy underwent 40.5% patients with sole biopsy and 78.7% patients with resection. By a biopted patient group 6-month survival was 23.8% and 12-month survival was 14.3%, by a resected patient group it was 57.7% and 34.3%, respectively. Others data will be discussed. CONCLUSION: In our health system, first of all patient with GBM is encountered by neurologist and neurosurgeon. After surgery and histologic settlement, only oncologist is call for other therapy planning. But according literature, from oncologic point of view the GBM patient evaluation is realized regardless of surgery type. Moreover the assessment of resection radicality is not concluded frequently from the early postresection MRI but sole from the surgery protocol. Based our data, the sufficient resection is an initial and crucial treatment strategy for GBM, making essential condition for ensuing oncologic treatment. The goal of GBM resection is cytoreduction, intracranial pressure releasing, corticotherapy restrain, impairment of tumour cell environment integrity and last (but not least) histological diagnosis. Support in part by grant of IGA of Ministry of Health, Czech Republic No. NT11065-5/5/2010. Support in part by grant of IGA of Ministry of Health, Czech No. NT13581-4/2012(86-91).