Abstract
Background
A growing number of studies demonstrated that awake surgery for lower-grade glioma results in both good functional and oncological outcome. However, indication of awake surgery for glioblastoma (GBM) has not been defined. Here, we intend to determine the indication of awake surgery for GBM based on the functional data at chronic phase.
METHODS
A total of 29 patients with GBM who underwent awake surgery between May 2012 and March 2018 were included (age: mean, 52.7; standard deviation [SD], 11.5). Additionally, 41 GBM patients (age, 65.4; SD, 11.4) who underwent surgery with general anesthesia (GA) were included as historical control. The Karnofsky Performance Status (KPS) of both groups were collected at pre- and postoperative 3 month (chronic phase). Moreover, to investigate factors relating to KPS score at chronic phase, multivariate analysis with following explanatory variables were performed: age, preoperative KPS score, genetic mutation, eloquent area, resected volume, laterality, and time of surgery.
RESULTS
The rate of KPS score preservation was significantly higher in awake surgery group (72.4%) than that of GA group (51.2%, p=0.03). Factors that influence the KPS score at chronic phase were age and preoperative KPS score (p=0.014, p. CONCLUSIONS:
Awake surgery for GBM patients is useful to preserve independence level at chronic phase. In the view of preservation of preoperative independence level, indication of awake surgery is KPS ≥ 90 and age ≤ 64.