Impact of gross-total resection versus other extent of resections for the overall survival of anaplastic astrocytoma

Abstract

Aim: We aim to assess the overall survival (OS) in patients with Anaplastic Astrocytoma (AA) undergoing gross total resection (GTR) as compared to partial resection (PR) subtotal resection (STR), or biopsy. Methods: This systematic review followed Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. An electronic search from PubMed/Medline was conducted from their inception to 26th April 2022. We included AA patients undergoing any surgical intervention resulting in GTR, PR, STR or biopsy. We did not include letters, case reports, abstracts, conference papers, reviews, and studies where full text was unavailable. We included only those articles which were published in English. Results: Five cohorts were used in this study. Two studies assessed OS in GTR, PR/STR and biopsy, while one study compared GTR and STR/biopsy. Another study was used to compare OS between GTR and local excision/STR, and another was used to assess the complications/benefits of these surgeries. Three studies showed a significant increase in OS in patients who underwent GTR compared to the other interventions, while one study showed a non-significant effect on OS (p= 0.249). Conclusion: Our study concluded a significant increase in OS when patients with AA had GTR instead of STR, PR or biopsy. Although these surgeries might carry some disadvantages, GTR allows a more positive effect on neurological status. Still, more studies need to be conducted to assess the efficiency of these surgeries.

Keywords

• anaplastic astrocytoma
• gross total resection
• subtotal resection
• overall survival