Introduction: The aggressive nature of glioblastoma multiforme shortens median survival inspite of maximal conventional treatments. We evaluated the impact of proactive multiple surgeries approach on the median survival time.

Methods: Clinical data and outcome of 44 patients treated for primary gioblastoma multiforme (GBM) by senior author (A.F.K.) were retrospectively analyzed using Kaplan-Meier survival curve. 27 patients underwent a proactive multiple surgeries approach for radiologic recurrence irrespective of clinical symptoms resulting in 43 surgeries.

Results: There were 26 males and 18 females with median age 59 y. Average age 60 (from 29 to 85 y). Average f-up was 17.21 +/- 18.64 mos. Group 1 (17 patients) underwent conventional multidisciplinary treatment including one initial surgery followed by radiation and chemotherapy. Group 2 (27 patients) underwent a more aggressive proactive multiple surgeries based on early signs of radiologic recurrence. Median survival time for group 1 was 14 mos. Group 2 did not reach median survival time during follow up period (p= 0.0011). Mortality rate for group one was – 82% and for group 2 - 39%;

Conclusions: A strategy of proactive scheduled multiple surgeries approach for GBM based on radiologic occurrence and irrespective of clinical symptomatology results in a significant longer median survival and improvement quality of life.

Patient Care: Proactive treatment lenghtens survival and quality of life.

Learning Objectives: 1. To understand the positive impact of aggressive proactive multidisciplinary treatment approach on the median survival time of patient with GBM.

References: Dolecek TA, Propp JM, Stroup NE, et al: CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009. Neuro Oncol 14 Suppl 5:v1-49, 2012