CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
DOI: 10.1055/s-0040-1718424
Original Article | Artigo Original

Effect of the Extent of Resection on Survival Outcome in Glioblastoma: Propensity Score Approach

1  Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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1  Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
› Author Affiliations

Abstract

Objective To evaluate the effectiveness of the extent of resection (EOR) on survival outcome using propensity score-based approaches.

Materials and Methods A retrospective cohort study was performed in patients with newly diagnosed glioblastoma. Propensity score matching (PSM) and propensity score regression adjustment were used in the matched and unmatched dataset, respectively. Therefore, the Kaplan-Meier survival curve and Cox's regression analyses were performed to determine the effect of the EOR on survival outcomes.

Results One hundred and sixty-eight patients were included for analyzes. The total tumor resection in the unmatched dataset was 22.6% of all cases. Using PSM, incomplete tumor resection had an unfavorable survival outcome when compared with total tumor resection (hazard ratio (HR) 2.92, 95% confidence interval [CI] 1.72–4.94). Additionally, biopsy and partial tumor resection were significantly associated with poor prognosis when compared with total tumor resection using propensity score regression adjustment (HR of biopsy 1.89, 95%CI 1.13–3.16 and HR of partial resection 1.89, 95%CI 1.28–2.80).

Conclusions Patients with total tumor resection tend to have a more favorable prognosis than patients with partial tumor resection. The propensity score-based analysis is an alternative approach to evaluate the effect of an intervention that has limitations to perform a randomized controlled trial.

Authors' Contributions

Conception and design: T. T.


Administrative support: T. T., S. M.


Provision of study materials or patients: T. T., S. M.


Collection and assembly of data: T. T., S. M.


Data analysis and interpretation: T. T.


Manuscript writing: All authors


Final approval of manuscript: All authors


Transparency Declaration

Part of the study population was obtained from the studies by Tunthanathip et al.[9] [14] However, the present study focused on the effect of the EOR on prognosis.




Publication History

Received: 20 April 2020

Accepted: 05 August 2020

Publication Date:
16 October 2020 (online)

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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