Re-resection at first recurrence is associated with prolonged survival in young patients with high-grade glioma: A multi-center study

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ID: 328004
2026
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Abstract
Abstract Background Surgical resection remains standard of care for high-grade glioma. It is unclear, however, whether re-resection at the time of first recurrence confers further survival benefit in young patients. Methods This multi-center, retrospective cohort study included patients age 0-21 years with supratentorial high-grade glioma who underwent gross total or near total resection at time of initial diagnosis which subsequently recurred. Patients were grouped by therapeutic re-resection at first recurrence. Post-recurrence overall survival was assessed with Kaplan–Meier methods, multivariable Cox regression, and propensity score–matched analyses. Results 44 patients with a median age of 12.5 years from 7 institutions were included. 61% (n = 27) underwent re-resection and 39% (n = 17) did not. The two groups (re-resection and no re-resection) did not significantly differ in sex, age at recurrence, functional status, pathology, chemotherapy and radiation exposure, or institution (all p > 0.05). Kaplan–Meier analysis demonstrated significantly longer post-recurrence overall survival with re-resection compared with no re-resection (median 24.6 vs 8.5 months; log-rank p = 0.0001). Patients who underwent re-resection had a 73% lower hazard of death after recurrence compared with patients who did not undergo re-resection by multivariable Cox regression (HR 0.27, 95% CI 0.10–0.69; p = 0.006) or by propensity score matching analyses (HR 0.27, 95% CI 0.11–0.68; p = 0.005). Conclusions Therapeutic re-resection at first recurrence was associated with improved post-recurrence survival which remained significant after multivariable adjustment or propensity score matching. This study provides evidence for re-resection in recurrent high-grade glioma in young patients.
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Authors David Giles, Jing Wang, Markus Anzaldua-Campos, Uma Mani, Ryan Harrigan, Kaethe Leonard, Bethany Y. Norton, Breanne Reisen, Diana Chang, Pavan Guttipatti, Sage Rahm, Anastasia Arynchyna-Smith, James M. Johnston, Todd Hankinson, Anthony Wang, Michael Dewan, Peter Chiarelli, Jason Hauptman, Jennifer M. Strahle, Jarod L. Roland, Michael DeCuypere, Eric M. Thompson
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Journal Neuro-Oncology Advances
Year 2026
DOI
10.1093/noajnl/vdag237
URL
https://doi.org/10.1093/noajnl/vdag237
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