10065-ST-5 Reoperation for recurrent adult type glioma

Abstract There is no consensus regarding the benefit of repeat resection for enhancing survival or quality of life in patients with recurrent adult-type gliomas. In this study, we retrospectively reviewed the outcomes of reoperation for recurrent adult-type gliomas performed at our hospital. In addition, propensity score matching was used to compare survival with the single-operation group. Reoperations were performed on 24 patients, including astrocytoma, IDH-mutant: 5 cases (20%), oligodendroglioma, IDH-mutant and 1p/19q codelted: 13 (54%), glioblastoma, IDH-wildtype: 5 (20%), and diffuse glioma, NOS: 1 (4%). The median age was 42. 5 years, and the median time between first surgery and reoperation was 91 months. Awake surgery was performed in 4 patients (17%), and gross total resection was achieved in 12 (50%). The overall median survival was 82 months for astrocytoma, 191 months for oligodendroglioma, and 41 months for glioblastoma (Log-rank, P value = 0.001). Surgical complications included neurological deterioration in 1 case (4%) and Clavien-Dindo classification IIIb or higher in 3 cases (12. 5%). Comparison of median survival using propensity score matching showed 33 months in the single-operation group and 123 months in the reoperation group (Log-rank, P value = 0.001). Reoperation for recurrent adult-type gliomas is expected to provide palliation of symptoms, histologic diagnosis, enhanced postoperative therapy efficacy, and prolonged survival. However, wound complications can delay additional postoperative therapy and consequently shorten survival. Further study is needed to determine in which cases reoperation can be performed safely and beneficially.