P.165 Surgery for recurrent GBM: deciding when to operate

Abstract

Background: Previous studies have found conflicting results regarding the role of repeat surgery on overall survival (OS) in patients with GBM. We used a novel approach that includes time to tumour recurrence as an additional prognostic factor in order to determine which patients benefit most from repeat surgery. Methods: A retrospective chart review from 1992-2018 was performed on all adult (≥ 18 years old) patients with primary GBM that received surgery for recurrent disease and compared to publicly available data from The Cancer Genome Atlas (TCGA) of adult patients with primary GBM that did not undergo surgery for recurrent disease. Results: A total of 672 adult patients with GBM were included in the study, including 87 that received surgery at tumour recurrence (surgery cohort). The surgery cohort had longer OS and similar complication rates to those that did not receive surgery at recurrence, independent of time to tumour recurrence (p < 0.0001 and p = 0.4, respectively). Within the surgery cohort, patients with tumour recurrence >6 months demonstrated additional survival benefit (p < 0.0001). Conclusions: Surgery for recurrent GBM leads to improved survival without increased complications. Patients with tumour recurrence >6 months benefit most from repeat surgery.