{"doi":"10.3171/2020.10.jns203366","title":"Influence of supramarginal resection on survival outcomes after gross-total resection of IDH–wild-type glioblastoma","abstract":"OBJECTIVE: The authors' goal was to use a multicenter, observational cohort study to determine whether supramarginal resection (SMR) of FLAIR-hyperintense tumor beyond the contrast-enhanced (CE) area influences the overall survival (OS) of patients with isocitrate dehydrogenase-wild-type (IDH-wt) glioblastoma after gross-total resection (GTR). METHODS: The medical records of 888 patients aged ≥ 18 years who underwent resection of GBM between January 2011 and December 2017 were reviewed. Volumetric measurements of the CE tumor and surrounding FLAIR-hyperintense tumor were performed, clinical variables were obtained, and associations with OS were analyzed. RESULTS: In total, 101 patients with newly diagnosed IDH-wt GBM who underwent GTR of the CE tumor met the inclusion criteria. In multivariate analysis, age ≥ 65 years (HR 1.97; 95% CI 1.01-2.56; p < 0.001) and contact with the lateral ventricles (HR 1.59; 95% CI 1.13-1.78; p = 0.025) were associated with shorter OS, but preoperative Karnofsky Performance Status ≥ 70 (HR 0.47; 95% CI 0.27-0.89; p = 0.006), MGMT promotor methylation (HR 0.63; 95% CI 0.52-0.99; p = 0.044), and increased percentage of SMR (HR 0.99; 95% CI 0.98-0.99; p = 0.02) were associated with longer OS. Finally, 20% SMR was the minimum percentage associated with beneficial OS (HR 0.56; 95% CI 0.35-0.89; p = 0.01), but > 60% SMR had no significant influence (HR 0.74; 95% CI 0.45-1.21; p = 0.234). CONCLUSIONS: SMR is associated with improved OS in patients with IDH-wt GBM who undergo GTR of CE tumor. At least 20% SMR of the CE tumor was associated with beneficial OS, but greater than 60% SMR had no significant influence on OS.","journal":"Journal of neurosurgery","year":2021,"id":152760,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":73,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.5712,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":266304,"name":"Ricardo A. Domingo","orcid":"0000-0002-8950-1762","position":1,"is_corresponding":false},{"id":417851,"name":"Shashwat Tripathi","orcid":"0000-0001-8172-7532","position":2,"is_corresponding":false},{"id":507003,"name":"Gaetano De Biase","orcid":"0000-0001-5803-0657","position":3,"is_corresponding":false},{"id":649054,"name":"Desmond Brown","orcid":null,"position":4,"is_corresponding":false},{"id":633087,"name":"Oluwaseun O. Akinduro","orcid":"0000-0003-0110-5202","position":5,"is_corresponding":false},{"id":649055,"name":"Andres Ramos-Fresnedo","orcid":null,"position":6,"is_corresponding":false},{"id":382542,"name":"David S. Sabsevitz","orcid":"0000-0002-0355-5234","position":7,"is_corresponding":false},{"id":417852,"name":"Bernard R. Bendok","orcid":"0000-0002-3506-3074","position":8,"is_corresponding":false},{"id":649056,"name":"Wendy Sherman","orcid":null,"position":9,"is_corresponding":false},{"id":225610,"name":"Ian F. Parney","orcid":"0000-0002-9702-8047","position":10,"is_corresponding":false},{"id":334514,"name":"Mark E. Jentoft","orcid":"0000-0002-2939-5259","position":11,"is_corresponding":false},{"id":266303,"name":"Erik H. Middlebrooks","orcid":"0000-0002-4418-9605","position":12,"is_corresponding":false},{"id":435836,"name":"Fredric B. Meyer","orcid":"0000-0002-4310-7962","position":13,"is_corresponding":false},{"id":334515,"name":"Kaisorn L. Chaichana","orcid":"0000-0002-9775-8912","position":14,"is_corresponding":false},{"id":649057,"name":"Alfredo Quinones-Hinojosa","orcid":null,"position":15,"is_corresponding":false},{"id":266305,"name":"Tito Vivas-Buitrago","orcid":"0000-0002-1096-3471","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-18T23:43:34.972031Z","pmid":"34087795","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}