https://orcid.org/0009-0008-1200-745X
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Nina C Teske, Leonard B Jung, Nico Teske, Niklas Thon, Jörg-Christian Tonn, Philipp Karschnia, The inconsistent terminology for the extent of resection in glioblastoma: A systematic review on 6 decades of neuro-oncological studies, Neuro-Oncology, Volume 27, Issue 2, February 2025, Pages 583–585, https://doi.org/10.1093/neuonc/noae254
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In patients with newly diagnosed glioblastoma, more extensive resection translates into prolonged survival.1,2 Terminology to describe the extent of resection (EOR) has been inconsistently applied across clinical studies which may introduce prognostic imbalances when comparing studies from different institutions.3 To systematically characterize the current terminology for glioblastoma resection, we screened neuro-oncological studies published between 01/1966 and 01/2024 in the PubMed database (MeSH term: glioblastoma; non-MeSH terms: EOR, resection, survival). The studies ultimately included data from 1979 to 2023. For studies on adult patients with supratentorial glioblastoma reporting EOR, a standardized set of semantic and clinical variables was extracted to delineate the terminology for EOR.
A total of 1862 neuro-oncological studies were identified, and 173 studies (prospective: 74, retrospective: 99) reported on EOR in newly diagnosed glioblastoma. A broad range of 18 different semantic terms was applied to describe varying amounts of residual tumor (Figure 1A). Here, 6 studies reported on resection beyond the contrast-enhancing tumor margins which was most predominantly referred to as “supramaximal” (n = 2; 33.3%) or “supramarginal” resection (n = 2; 33.3%). In total, 162 studies discussed maximal resection of the contrast-enhancing tumor portion, mainly described as “gross-total” (n = 97; 59.9%) or “complete” resection (n = 33; 20.4%). A majority of 168 studies referred to incomplete resections as either “subtotal” (n = 91; 54.2%) or “partial” resection (n = 56; 33.3%). In line with this inconsistent terminology, only every second study (n = 91; 52.6%) defined thresholds required for patients to match into a specific resection category.
