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@ARTICLE{Teske:305537,
      author       = {N. Teske$^*$ and A. Dono and J. S. Young and S. T. Juenger
                      and G. C. Youssef and L. Häni and T. Sciortino and F. Bruno
                      and J. Dietrich and C. Y. Mau and M. Weller and J. Beck and
                      S. Hervey-Jumper and A. M. Molinaro and S. M. Chang and M.
                      van den Bent and M. A. Vogelbaum and M. I. Ruge and D. P.
                      Cahill and R. Rudà and L. Bello and S. J. Grau and O.
                      Schnell and R. Y. Huang and P. Y. Wen and N. Tandon and M.
                      S. Berger and J.-C. Tonn$^*$ and Y. Esquenazi and P.
                      Karschnia$^*$},
      title        = {{A}ssociations of supramaximal resection with outcome in
                      glioblastoma across age groups: a report of the {RANO}
                      resect group.},
      journal      = {Neuro-Oncology},
      volume       = {nn},
      issn         = {1522-8517},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {DKFZ-2025-02211},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {The oncological role of resection in elderly patients with
                      glioblastoma remains controversial. We evaluated the value
                      of resection in patients ≥65 years with (I) newly
                      diagnosed and (II) recurrent glioblastoma by comparing the
                      prognostic relevance of extent of resection to patients <65
                      years.The international RANO resect group retrospectively
                      collected patients with newly diagnosed and recurrent
                      IDH-wildtype glioblastoma from ten neuro-oncological
                      centers. Associations of residual tumor with molecular and
                      clinical markers and survival were analyzed.1260 patients
                      with newly diagnosed glioblastoma were identified, including
                      512 patients ≥65 years. Lower postoperative
                      contrast-enhancing tumor volumes were favorably associated
                      with survival on uni- and multivariate analyses; however,
                      the associations with outcome were more pronounced in
                      younger patients. Only in patients <65 years, supramaximal
                      resection was associated with more favorable survival (40
                      vs. 20 months, p=0.001). In 310 patients with first
                      recurrence (≥65 years: 92), maximal resection of
                      contrast-enhancing tumor was associated with favorable
                      outcomes, particularly in younger patients. Neither older
                      nor younger patients had favorable outcome associations of
                      supramaximal resection in the recurrent setting. All
                      findings were confirmed in propensity-score-matched analyses
                      to minimize confounding effects of inherent differences in
                      demographic and clinical markers (including second-line
                      treatments) between older and younger patients.While
                      complete contrast-enhancing tumor resection is prognostic
                      for favorable outcomes in older patients, associations of
                      supramaximal resection with improved outcomes were only
                      retained in younger patients with newly diagnosed disease.
                      Those findings support stratified surgical approaches.},
      keywords     = {extent of resection (Other) / glioblastoma (Other) /
                      outcome (Other) / patient stratification (Other) / surgery
                      (Other)},
      cin          = {MU01},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41137668},
      doi          = {10.1093/neuonc/noaf239},
      url          = {https://inrepo02.dkfz.de/record/305537},
}