‘Recurrent’ glioblastoma multiforme, when should we reoperate?

Abstract

The surgical management of recurrent glioblastoma multiforme is controversial. Recent publications suggest that re-operation provides 3–5 months median survival, without significant increases in morbidity or martality. Age (≤50 years, although older patients may also benefit) and performance status (Karnofsky performance score ≥60–70) are the most important factors. Reresection not only improves symptoms and maintains quality of life, it can delay symptom progression, reduce corticosteroid doses, and also improve response to (and allow intra-operative) chemotherapy and/or radiotherapy. Surgical treatment of recurrent glioblastoma multiforme in selected patients should always be considered.

Key words:

• Chemotherapy
• glioblastoma multiforme
• radiotherapy
• recurrence
• reoperation
• resection
• surgery
• glioma