Prognostic implications of the extent of surgical resection in patients with intracranial malignant gliomas

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Abstract
Background. The goal of treating patients with malignant gliomas by intracranial surgery has been to remove as much tumor as possible without causing new neurologic deficits. However, it is still debatable whether the degree of surgical resection correlates with survival times of patients with supratentorial gliomas. Methods. One hundred and one patients with supratentorial malignant gliomas who underwent either a gross total resection, a subtotal resection, and/or a partial resection were examined. A correlation between their length of survival and the degree of surgical resection was determined. Results. The survival rates of patients who underwent total resections were significantly higher than those of patients who underwent subtotal or partial resections (P < 0.01). However, there was no significant difference in the survival rates between the subtotal and partial resection groups. These results also were confirmed by independent variables, such as age, location of the tumors, and histologic subtypes, with the exceptions of temporal gliomas and those younger than 60 years. Conclusions. The favorable prognosis of patients with malignant gliomas depends upon the total resection these tumors. These findings should be of help in designing preoperative surgical intervention strategies. Cancer 1995;75:2727–31.