PMID- 2827051
OWN - NLM
STAT- MEDLINE
DCOM- 19880204
LR  - 20220330
IS  - 0148-396X (Print)
IS  - 0148-396X (Linking)
VI  - 21
IP  - 5
DP  - 1987 Nov
TI  - Reoperation in the treatment of recurrent intracranial malignant gliomas.
PG  - 607-14
AB  - Fifty-five consecutive patients with recurrent intracranial malignant gliomas 
      were reoperated at Memorial Sloan-Kettering Cancer Center from 1972 to 1983. The 
      patients were 10 to 70 years old (median, 48 years). Thirty-five patients (64%) 
      had glioblastoma multiforme, and 20 (36%) had anaplastic astrocytoma. The median 
      interval between the first operation and reoperation was 43 weeks. The Karnofsky 
      rating before reoperation ranged from 40 to 90 (median, 70). Eleven patients 
      (20%) had more than one reoperation. The mortality rate was 1.4% per procedure, 
      and the morbidity rate was 16% per procedure. After reoperation, 41 patients 
      (75%) had chemotherapy and/or radiation therapy. The median survival for all 
      patients was 92 weeks. The median survival after reoperation was 36 weeks. 
      Patients with Karnofsky ratings of greater than or equal to 70, with anaplastic 
      astrocytomas, or in whom gross total removal of the tumor was undertaken lived 
      longer than their respective counterparts (P less than 0.05). Prereoperation 
      Karnofsky rating and extent of surgical resection were the most important 
      independent factors related to survival after reoperation according to 
      multivariate analysis (P less than 0.01 and P less than 0.05, respectively). 
      Twenty-five patients (45%) had improved Karnofsky ratings after reoperation, and 
      the 32 patients (58%) who were independent after reoperation were able to stay so 
      for more than 6 months of their survival time (median value). Reoperation is 
      feasible and can be accomplished with acceptable mortality and morbidity. When 
      intracranial malignant gliomas recur, the combined use of reoperation and 
      adjuvant therapy prolongs good quality life.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Ammirati, M
AU  - Ammirati M
AD  - Division of Neurosurgery, Northwestern University Medical School, Chicago, 
      Illinois.
FAU - Galicich, J H
AU  - Galicich JH
FAU - Arbit, E
AU  - Arbit E
FAU - Liao, Y
AU  - Liao Y
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Astrocytoma/*surgery
MH  - Brain Neoplasms/*surgery
MH  - Child
MH  - Combined Modality Therapy
MH  - Disability Evaluation
MH  - Female
MH  - Follow-Up Studies
MH  - Glioblastoma/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/*surgery
MH  - Postoperative Complications/mortality
MH  - Reoperation
EDAT- 1987/11/01 00:00
MHDA- 1987/11/01 00:01
CRDT- 1987/11/01 00:00
PHST- 1987/11/01 00:00 [pubmed]
PHST- 1987/11/01 00:01 [medline]
PHST- 1987/11/01 00:00 [entrez]
AID - 10.1227/00006123-198711000-00001 [doi]
PST - ppublish
SO  - Neurosurgery. 1987 Nov;21(5):607-14. doi: 10.1227/00006123-198711000-00001.