2026 American Academy of Neurology Abstract Website

Objective:

This study evaluates a single center’s practice for surgical options in recurrent glioblastoma.

Background:

Standard of care for glioblastoma consists of maximal surgical resection followed by radiotherapy with concomitant and maintenance temozolomide. Despite treatment, nearly all patients experience tumor progression with a median survival of less than 15 months. Disease recurrence is common, and there is no standard treatment for recurrence. We investigated whether a second surgery to resect glioblastoma recurrence provides survival benefit.

Design/Methods:

We reviewed 98 patients treated for glioblastoma from 2021 to 2025 and identified 19 patients who had a resection for recurrent glioblastoma. All patients had had a resection for the primary glioblastoma before resection of the recurrence.

Results:

Eight (42%) patients had a tumor with methylated MGMT promoter, and 11 (58%) had a tumor with unmethylated MGMT promoter. 16 (84%) patients had good functional status defined as Karnofsky performance score of ≥ 70 before second surgery. All patients had their second surgery performed at specialized academic centers. 14 patients (74%) had their second surgery at the same tertiary center where they had surgery for their primary tumor, while 5 patients (26%) had their second surgery at a different center. Time between surgery for primary tumor and surgery for recurrence ranged from 3.6 months to 44 months, with an average of 12 months. Survival after diagnosis ranged from 6.3 months to 50 months, with an average survival of 24 months. Survival after second surgery ranged from 2.7 months to 36 months, with an average survival of 12 months.

Conclusions:

Our data show there may be longer survival in patients who received surgery for recurrent glioblastoma. Further studies with matched controls will be performed. Certain patients may be more likely to benefit based on their functional status and access to specialized centers.