Clinical and Treatment Determinant of Prognosis in Glioblastoma

Gliomas represent the most common primary malignant brain tumors in adults, with glioblastoma (WHO grade 4) being the most aggressive subtype. Despite advances in surgical techniques, radiotherapy, and chemotherapy, prognosis remains poor, particularly for high-grade gliomas. Maximal safe surgical resection is considered a cornerstone in the management of gliomas. Several studies suggest that a greater extent of resection (EOR) is associated with improved overall survival (OS) and progression-free survival (PFS), particularly in high-grade tumors. However, the benefit must be balanced against the risk of neurological deficits. Postoperative chemoradiotherapy, particularly with temozolomide, has become the standard of care for high-grade gliomas. Despite this, the impact of EOR on outcomes in the context of adjuvant chemoradiotherapy remains a subject of ongoing investigation. This study aims to evaluate the prognostic significance of the extent of surgical resection in glioma patients who undergo postoperative chemoradiotherapy.