The Impact of Extent of Resection on the Prognosis of Glioblastoma Multiforme: A Systematic Review and Meta-analysis

Abstract

AIM: The aim of the study was to investigate the predictor factors of mortality describing the prognosis of primary surgical resection of glioblastoma multiforme (GBM). MATERIALS AND METHODS: A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to September 12, 2021. All statistical analysis was conducted in Review Manager 5.4.1. Studies meeting inclusion criteria were selected. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported in the hazards ratio (HR) and corresponding 95% confidence interval. RESULTS: Twenty-three cohort studies were selected for meta-analysis. There was a statistically significant effect of extent of resection (EOR) on prognosis of surgery in GBM patients (HR = 0.90 [0.86, 0.95]; p < 0.0001; I2= 96%), male gender (HR= 1.19 [1.06, 1.34]; p = 0.002; I2 = 0%), and decrease Karnofsky Performance Status (HR= 0.97 [0.95, 0.99]; p = 0.003; I2 = 90%). Age and tumor volume were also analyzed in the study. CONCLUSION: The results of our meta-analysis suggested that age, gender, pre-operative KPS score, and EOR have significant effects on the post-surgical mortality rate; therefore, these factors can be used significant predictor of mortality in GBM patients