Can Extensive Resection of Butterfly Glioblastomas Prolong Life Expectancy and Quality? A Retrospective Cohort Study

Abstract The retrospective cohort study, spanning from 2014 to 2022, aimed to assess the effects of extensive surgical resection on patients diagnosed with butterfly glioblastomas (B-GBM). Encompassing 723 GBM patients, among whom 41 met the IDH wild-type B-GBM criteria, the study's methodology involved the classification of surgical cases into two groups of partial and extensive surgery that were performed by two different surgeons. Various factors such as age, sex, tumor location, and corpus callosum involvement were considered during the categorization process. Extensive resection yielded significantly longer time to recurrence/tumor-free period (TR/TFP) and overall survival (OS) when contrasted with partial resection. Despite the association of TERT gene mutation and EGFR amplification with shorter TR/TFP and OS, the findings underscore the potential of extensive surgical resection in enhancing the quality of life and extending TR/TFP for B-GBM patients, even in the context of adverse gene mutations. Notably, Karnofsky Performance Scale (KPS) scores indicated a superior quality of life post-extensive resection, with sustained improvement observed even upon recurrence. However, extensive resection's impact on OS was not statistically significant; nevertheless, it notably augmented TR/TFP.