{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T20:28:30Z","timestamp":1783888110887,"version":"3.55.0"},"reference-count":110,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The aim of this study was to answer the question whether quality of life and progression-free and overall survival are increased in adults with supratentorial malignant glioma who are treated with cytoreductive resection as compared with those who only undergo biopsy.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A literature search of the electronic databases MEDLINE, EMBASE, and CENTRAL was performed to identify relevant studies published before May 2008. Hand-searching of reference lists of the identified studies and relevant review articles was also performed. A study was considered eligible, regardless of study design (prospective or retrospective), if: 1) quality of life and\/or progression-free and\/or overall survival was compared among adult patients undergoing biopsy or resection, and 2) patient age and Karnofsky Performance Scale scores were not significantly different among the 2 groups compared.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>One randomized controlled trial and 4 retrospective studies (involving a total of 1111 patients) were found eligible for this systematic review. A meta-analysis of the eligible studies demonstrated a significant increase in overall survival in the patients treated with resection instead of biopsy (hazard ratio 0.61, 95% CI 0.52\u20130.71, p &lt; 0.0001, fixed-effect model). Although statistical pooling was not feasible, the available data suggest that quality of life was increased in patients treated with resection rather than biopsy, while there did not seem to be any significant difference in progression-free survival between the 2 groups.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Based on the best available evidence, it appears that cytoreductive resection in adults with supratentorial malignant glioma is associated with improved overall survival as compared with biopsy. However, well-designed prospective studies are needed for more solid conclusions to be drawn.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.7.jns09758","type":"journal-article","created":{"date-parts":[[2009,9,11]],"date-time":"2009-09-11T14:21:45Z","timestamp":1252678905000},"page":"1020-1032","source":"Crossref","is-referenced-by-count":36,"title":["Biopsy versus resection in the management of malignant gliomas: a systematic review and meta-analysis"],"prefix":"10.3171","volume":"112","author":[{"given":"Abraham","family":"Tsitlakidis","sequence":"first","affiliation":[{"name":"First Department of Neurosurgery, AHEPA University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Foroglou","sequence":"additional","affiliation":[{"name":"First Department of Neurosurgery, AHEPA University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos A.","family":"Venetis","sequence":"additional","affiliation":[{"name":"Unit for Human Reproduction, First Department of Obstetrics and Gynaecology, Papageorgiou General Hospital, Aristotle University of Thessaloniki; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Patsalas","sequence":"additional","affiliation":[{"name":"First Department of Neurosurgery, AHEPA University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Hatzisotiriou","sequence":"additional","affiliation":[{"name":"Agios Loukas Clinic, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Selviaridis","sequence":"additional","affiliation":[{"name":"First Department of Neurosurgery, AHEPA University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1121020","series-title":"Biophotonics International","first-page":"36","article-title":"Image processing with ImageJ","volume":"11","author":"Abramoff","year":"2004"},{"key":"b2-1121020","series-title":"Neurosurgery","first-page":"201","article-title":"Effect of the extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic astrocytomas","volume":"21","author":"Ammirati","year":"1987"},{"key":"b3-1121020","series-title":"AJNR Am J Neuroradiol","first-page":"488","article-title":"CT prognostic criteria of survival after malignant glioma surgery","volume":"4","author":"Andreou","year":"1983"},{"key":"b4-1121020","series-title":"Strahlenther Onkol","first-page":"424","article-title":"Patterns of failure following CT-based 3-D irradiation for malignant glioma","volume":"177","author":"Aydin","year":"2001"},{"key":"b5-1121020","series-title":"J Neurosurg","first-page":"642","article-title":"Patterns of care and outcomes among elderly individuals with primary malignant astrocytoma","volume":"108","author":"Barnholtz-Sloan","year":"2008"},{"key":"b6-1121020","series-title":"Int J Radiat Oncol Biol Phys","first-page":"825","article-title":"Allelic loss of chromosome 1p and radiotherapy plus chemotherapy in patients with oligodendrogliomas","volume":"48","author":"Bauman","year":"2000"},{"key":"b7-1121020","series-title":"BMC Med Res Methodol","first-page":"50","article-title":"Development and validation of MIX: comprehensive free software for meta-analysis of causal research data","volume":"6","author":"Bax","year":"2006"},{"key":"b8-1121020","series-title":"J Neurovirol","first-page":"227","article-title":"Management of malignant glioma: role of surgery in relation to multimodality therapy","volume":"4","author":"Black","year":"1998"},{"key":"b9-1121020","series-title":"Crit Rev Oncol Hematol","first-page":"256","article-title":"Glioblastoma in the elderly: current and future trends","volume":"60","author":"Brandes","year":"2006"},{"key":"b10-1121020","series-title":"Semin Oncol","first-page":"58","article-title":"The treatment of elderly patients with high-grade gliomas","volume":"30","author":"Brandes","year":"2003"},{"key":"b11-1121020","series-title":"Semin Oncol","first-page":"10","article-title":"Factors influencing survival in high-grade gliomas","volume":"30","author":"Buckner","year":"2003"},{"key":"b12-1121020","series-title":"Cancer","first-page":"1617","article-title":"Patient age, histologic features, and length of survival in patients with glioblastoma multiforme","volume":"59","author":"Burger","year":"1987"},{"key":"b13-1121020","series-title":"Cancer","first-page":"1106","article-title":"Glioblastoma multiforme and anaplastic astrocytoma: pathologic criteria and prognostic implications","volume":"56","author":"Burger","year":"1985"},{"key":"b14-1121020","series-title":"Cancer","first-page":"1179","article-title":"Histologic factors of prognostic significance in the glioblastoma multiforme","volume":"46","author":"Burger","year":"1980"},{"key":"b15-1121020","series-title":"Curr Treat Options Oncol","first-page":"459","article-title":"Malignant gliomas","volume":"1","author":"Burton","year":"2000"},{"key":"b16-1121020","series-title":"Oncology of the Nervous System","first-page":"379","article-title":"Prognostic factors for malignant glioma","author":"Byar","year":"1983"},{"key":"b17-1121020","series-title":"Statistical Report: Primary Brain Tumors in the United States, 2000\u20132004","author":"CBTRUS","year":"2008"},{"key":"b18-1121020","series-title":"Cancer","first-page":"997","article-title":"Comparison of postoperative radiotherapy and combined postoperative radiotherapy and chemotherapy in the multidisciplinary management of malignant gliomas. 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