Abstract
Background
Despite the extent of resection affecting the overall survival of patients with gliomas, cytoreduction in patients with butterfly gliomas (BG) remains controversial. Contemporary studies suggest that wide removal is feasible, but there is a lack of controlled, randomized, multicenter studies on the subject. The aim of this study was to evaluate the impact of safe maximal surgical resection (SMSR) as a primary treatment strategy in patients with BG.
Methods
30 consecutive patients, primarily treated with neurosurgery, were categorized into Group-A when SMSR was equal to or greater than 50% and Group-B when it was less than 50% (biopsy). The groups were studied and compared for clinical, epidemiological, functionality, survival time (ST), and progression-free survival (PFS) characteristics. Results were analyzed by descriptive and inferential statistics.
Results
The most frequent tumors were glioblastoma IDH-wild type, WHO grade 4. Most patients (80%) had KPS < 70%, however, there was no significant worsening of functionality associated with interventions. Wider resection (Group-A) was associated with a better Kaplan-Meier curve and ST (68.35 versus 17.32 weeks, p = 0.014). PFS was also longer in this group (57.70 versus 4.77 weeks, p = 0.012). In multivariate analysis, resections > 50% were associated with reduced risk of recurrence (HR = 0.20, 95% CI 0.06–0.67, p = 0.009). Complication rates and functional decline were similar between groups.
Conclusion
Surgical resections (> 50%) in patients with BG improved ST and PFS without a significant increase in morbidity and dysfunction.