Lobectomy may be viable alternative surgical intervention for glioblastoma

Key takeaways:

• Researchers analyzed data from six studies on surgical intervention and outcomes in those with glioblastoma.
• The full effects of lobectomy can be determined with a larger data set.

Compared with gross total resection, lobectomy as a surgical intervention for individuals with glioblastoma had a more positive impact on progression-free and overall survival outcomes, according to a systematic review and meta-analysis.

“Glioblastoma remains the most common and most aggressive tumor of the central nervous system in adults, with median overall survival ranging from 14 to 20 months,” Christina K. Arvaniti, MD, neurosurgery resident at the University of Thessaly in Greece, and colleagues wrote in Brain and Spine. “Lobectomy, even though it is not considered the standard of care, could affect [overall survival], since it would provide the maximum cytoreductive option.”

Arvaniti and colleagues sought to determine how lobectomy measures up to existing surgical interventions such as gross total resection (GTR) for those with glioblastoma and whether it improved both progression-free survival (PFS) and overall survival (OS) in patients with brain tumors.

The researchers engaged in a systematic review and meta-analysis of existing literature by searching the PubMed, Scopus, and Web of Science databases from January 2013 through April 2023. They included six studies for analysis that featured comparisons between lobectomy and other surgical alternatives; surgical interventions attempted on patients aged 18 years and older; studies involving more than five participants; and studies published in an English peer-reviewed journal whose content comprised data on PFS, OS, seizure outcomes and incidence of complications.

All eligible studies were published between 2016 and 2021, with Germany producing three of the six studies. The others came from Egypt, Korea and the United States.

Data showed that lobectomy resulted in a mean OS of 25 months and PFS of 16.13 months, compared with 13.72 months and 8.77 months for GTR.

When comparing lobectomy with GTR, the researchers wrote that they found no statistically significant differences with respect to seizure management, length of stay, operation time or complications due to a limited data set.

“Lobectomy cannot be considered a panacea for [glioblastomas] and has certain indications, which need to be precisely outlines in the near future,” Arvaniti and colleagues wrote.