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We evaluated whether GTR versus less-than-GTR (&lt;\u2009GTR) was associated with overall survival across MGMT promoter methylation and chemoradiation strata.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 261 patients undergoing biopsy or resection for newly diagnosed IDH-wildtype glioblastoma at a single institution from 2010 to 2024. Extent of resection was dichotomized as GTR versus &lt;\u2009GTR, and chemoradiation was coded as receipt of postoperative radiation and temozolomide. Overall survival was assessed using Kaplan-Meier analysis and multivariable Cox models with prespecified EOR \u00d7 MGMT \u00d7 chemoradiation interaction testing, adjusted for age, KPS, tumor location, and mFI-5.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      GTR was associated with longer overall survival than &lt;\u2009GTR in the overall cohort and within all four MGMT \u00d7 chemoradiation strata. MGMT-methylated patients receiving chemoradiation had a median overall survival of 17.02 months after GTR versus 10.65 months after &lt;\u2009GTR (log-rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), and the model-derived adjusted hazard ratio for &lt;\u2009GTR versus GTR was 2.12 (95% CI 1.27\u20133.54;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). The three-way EOR \u00d7 MGMT \u00d7 chemoradiation interaction was not significant (likelihood-ratio\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.309). In a 6-week sensitivity analysis, all survival associations remained, but EOR \u00d7 chemoradiation was no longer significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GTR was associated with longer survival across all MGMT and chemoradiation-defined subgroups, including MGMT-methylated patients receiving chemoradiation. These findings are consistent with maximal safe resection when feasible but should be interpreted cautiously because of small subgroups as well as treatment-selection and immortal-time biases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-026-05725-x","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T09:44:24Z","timestamp":1784799864000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extent of resection and survival in IDH-wildtype glioblastoma: interaction with MGMT status and chemoradiation"],"prefix":"10.1007","volume":"179","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2636-0516","authenticated-orcid":false,"given":"Noah B.","family":"Drewes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Koutah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Carnduff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Chin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin R.","family":"Delfino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey W.","family":"Cozzens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce M.","family":"Frankel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"5725_CR1","doi-asserted-by":"publisher","first-page":"vi1","DOI":"10.1093\/neuonc\/noae145","volume":"26","author":"M Price","year":"2024","unstructured":"Price M, Ballard C, Benedetti J, Neff C, Cioffi G, Waite KA, Kruchko C, Barnholtz-Sloan JS, Ostrom QT (2024) CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2017\u20132021. 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