الفهرس 
ANATOMYOnly 14 pages are availabe for public view
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Abstract
Glioblastoma (GBM) is the most common and most aggressive
primary malignant brain tumor. It has a dismal prognosis. The
importance of the extent of resection for glioblastoma has been debated
for decades.
The presentation of a patient with newly diagnosed GBM can vary
greatly depending on the size and location of the tumor and the anatomic
structures of the involved brain.
Techniques like cortical mapping of the brain, fluorescence-guided
surgery, laser interstitial thermal therapy and intraoperative mass
spectrometry are used currently in the operating room for tumor resection.
The present study investigated the impact of the extent of resection
of a primary GBM on patients‘ survival, through systemically reviewing
the recent literature. Four electronic databases were systematically
searched, including PubMed, Embase, the Cochrane library, and Science
Direct to review the recent literature from January 2009 up till now.
Hazard ratios (HRs) or odds ratios (ORs) with corresponding 95%
confidence intervals (CIs) were used to express the summary effect
estimates using the random-effects model. Eight studies involving a total
of 2249 patients with high-grade glioma were included in this study. A
total of 1247 patients underwent gross total resection of the GBM and
1002 had an incomplete resection. The mean progression-free survival
(GTR vs incomplete resection) was 10 vs 6.3 months and the mean
overall survival (GTR vs incomplete resection) was 28.7 vs 13.5 months.
from our study, we found it remains unclear if GTR is safe and
actually improves the survival of patients with GBM. Future prospective
trials and a standardized definition of GTR are needed in addition to
understanding the genetic and clinical heterogeneity of GBM to improve
the therapeutic approach.