Aggressive repeat surgery for focally recurrent XXXX : outcomes and theoretical framework.

@entity1 @entity463 @entity5 @entity146
OBJECT The relative benefit of repeat surgery for recurrent @entity463 is unclear, in part due to the very heterogeneous nature of the @entity1 population and the effect of clinician philosophy on the duration and @entity146 of treatment. The authors sought to investigate the role of time to last recurrence on @entity1 outcomes following aggressive repeat surgery for recurrent @entity463 . METHODS The authors present outcomes in 104 @entity1 undergoing repeat surgery for focally recurrent @entity463 with at least 95% resection and adjuvant treatment at most recent prior surgery. In addition to common variables, they provide data regarding the period of progression-free survival (PFS) following an aggressive lesionectomy for focally recurrent @entity463 (T2) and the time the @entity5 took to recur since the previous surgery (T1). They term the ratio T1/T2 the relative aggressivity index (RAI). RESULTS The median PFS was 7.8 months, 6.0 months, and 4.8 months following the second, third, and fourth-sixth craniotomies, respectively. Importantly, there was a wide range of outcomes, with time to postoperative recurrence ranging from 1 to 24 months in this group. Analysis showed no meaningful relationship between T1 and T2, meaning that previous PFS is entirely unable to predict the PFS that another surgery will provide the @entity1 . CONCLUSIONS Repeat surgery for @entity463 is beneficial in many cases, however this is hard to predict preoperatively. Often, surgery can provide the @entity1 with a good period of disease freedom, but this is variable and in general it is not possible to reliably predict who these @entity1 are.
