Meta-analysis Of The Relationship Between Expand The Extent Of Resection Of Glioblastoma And Prognosis

Objective: Gliblastoma(GBM)tumor cells tend to infiltrate the surrounding normal brain tissue,even if the solid tumor gross-total resection(GTR)is achieved,there will be recurrence,and the patient’s prognosis is poor.Although a wider range of resection of GBM has been used in current treatments,the quality of the existing literature has not yet been clarified,and there is no consensus on the potential survival benefits and safety of expanded resection.The purpose of this study is to explore the effect of expanded resection of GBM on the prognosis of patients.Methods:Through searching the literature that has been published in English and Chinese database,such as Pub Med,Embase,Web of Science,Cochrane Library,China National Knowledge Infrastructure(CNKI)and Chinese Bio Medical Literature Database(CBM),all relevant academic articles from the establishment of the database to January 2021.Endnote X9 software was used for literature management,and the literature was screened according to the inclusion and exclusion criteria.The quality of the literature was evaluated using the Newcastle-Ottawa Scale(NOS).The literature was meta-analyzed with Review Manager 5.4 software,the extracted effect sizes were combined,and then the heterogeneity,sensitivity,and risk of bias were evaluated and subgroup analysis was performed.Results:Through screening,9 articles were included for meta-analysis,and the effects of resection range on OS and PFS of GBM patients were evaluated.The heterogeneity test showed that there is no heterogeneity or slight heterogeneity in all the documents,and the results are stable and there is no publication bias.Compared with GTR,expanding the extent of resection of resection can improve patients’ PFS and OS,and the difference is statistically significant(p<0.05).And expanding the extent of resection did not bring additional neurological damage to the patient.Conclusion:Compared with GTR,expanding the extent of resection can improve OS and PFS in GBM patients,and does not seem to produce additional neurological damage.In the future,more prospective trials are needed to confirm the effectiveness and safety of expanded resection,and to standardize the definition of expanded resection.