TY - JOUR
T1 - Imaging timing after surgery for glioblastoma: an evaluation of practice in Great Britain and Ireland (INTERVAL-GB)- a multi-centre, cohort study
AU - INTERVAL-GB Collaborative
AU - Neurology and Neurosurgery Interest Group (NANSIG)
AU - British Neurosurgical Trainee Research Collaborative (BNTRC)
AU - Gillespie, Conor s
AU - Bligh, Emily r
AU - Poon, Michael tc
AU - Islim, Abdurrahman i
AU - Solomou, Georgios
AU - Gough, Melissa
AU - Millward, Christopher p
AU - Rominiyi, Ola
AU - Zakaria, Rasheed
AU - Price, Stephen j.
AU - Watts, Colin
AU - Camp, Sophie
AU - Booth, Thomas c
AU - Thompson, Gerard
AU - Mills, Samantha j
AU - Waldman, Adam
AU - Brennan, Paul m.
AU - Jenkinson, Michael d
AU - Abdullmalek, Hidayatul
AU - Abualsaud, Suhaib
AU - Adegboyega, Gideon
AU - Afulukwe, Chinelo
AU - Ahmed, Najma
AU - Amoo, Michael
AU - Al-Sousi, Abdelsalam nedal
AU - Al-Tamimi, Yahia
AU - Anand, Ajitesh
AU - Barua, Neil
AU - Bhatt, Harsh
AU - Boiangiu, Ion
AU - Boyle, Abbey
AU - Bredell, Christiaan
AU - Chaudri, Talhah
AU - Cheong, Jeremy
AU - Cios, Ana
AU - Coope, David
AU - Coulter, Ian
AU - Critchley, Giles
AU - Davis, Harriet
AU - De luna, Paolo jose
AU - Dey, Nayan
AU - Duric, Bea
AU - Egiz, Abdullah
AU - Ekert, Justyna o.
AU - Egu, Chinedu brian
AU - Ekanayake, Jinendra
AU - Elso, Anna
AU - Martin, Andrew j
AU - Smith, Stuart
AU - Lee, Seong hoon
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/9/1
Y1 - 2024/9/1
N2 - PURPOSE: Post-operative MRI is used to assess extent of resection, monitor treatment response and detect progression in high-grade glioma. However, compliance with accepted guidelines for follow-up MRI, and impact on management/outcomes is unclear. METHODS: Multi-center, retrospective observational cohort study of patients with confirmed WHO grade 4 glioma (August 2018-February 2019) receiving oncological treatment. PRIMARY OBJECTIVE: investigate follow-up MRI surveillance practice and compliance with recommendations from NICE (Post-operative scan < 72h, MRI every 3-6 months) and EANO (Post-operative scan < 48h, MRI every 3 months). RESULTS: There were 754 patients from 26 neuro-oncology centers with a median age of 63 years (IQR 54-70), yielding 10,100 (median, 12.5/person, IQR 5.2-19.4) person-months of follow-up. Of patients receiving debulking surgery, most patients had post-operative MRI within 72 h of surgery (78.0%, N = 407/522), and within 48 h of surgery (64.2%, N = 335/522). The median number of subsequent follow-up MRI scans was 1 (IQR 0-4). Compliance with NICE and EANO recommendations for follow-up MRI was 52.8% (N = 398/754) and 24.9% (N = 188/754), respectively. On multivariable Cox regression analysis, increased time spent in recommended follow-up according to NICE guidelines was associated with longer OS (HR 0.56, 95% CI 0.46-0.66, P < 0.001), but not PFS (HR 0.93, 95% CI 0.79-1.10, P = 0.349). Increased time spent in recommended follow-up according to EANO guidelines was associated with longer OS (HR 0.54, 95% CI 0.45-0.63, P < 0.001) but not PFS (HR 0.99, 95% CI 0.84-1.16, P = 0.874). CONCLUSION: Regular surveillance follow-up for glioblastoma is associated with longer OS. Prospective trials are needed to determine whether regular or symptom-directed MRI influences outcomes.
AB - PURPOSE: Post-operative MRI is used to assess extent of resection, monitor treatment response and detect progression in high-grade glioma. However, compliance with accepted guidelines for follow-up MRI, and impact on management/outcomes is unclear. METHODS: Multi-center, retrospective observational cohort study of patients with confirmed WHO grade 4 glioma (August 2018-February 2019) receiving oncological treatment. PRIMARY OBJECTIVE: investigate follow-up MRI surveillance practice and compliance with recommendations from NICE (Post-operative scan < 72h, MRI every 3-6 months) and EANO (Post-operative scan < 48h, MRI every 3 months). RESULTS: There were 754 patients from 26 neuro-oncology centers with a median age of 63 years (IQR 54-70), yielding 10,100 (median, 12.5/person, IQR 5.2-19.4) person-months of follow-up. Of patients receiving debulking surgery, most patients had post-operative MRI within 72 h of surgery (78.0%, N = 407/522), and within 48 h of surgery (64.2%, N = 335/522). The median number of subsequent follow-up MRI scans was 1 (IQR 0-4). Compliance with NICE and EANO recommendations for follow-up MRI was 52.8% (N = 398/754) and 24.9% (N = 188/754), respectively. On multivariable Cox regression analysis, increased time spent in recommended follow-up according to NICE guidelines was associated with longer OS (HR 0.56, 95% CI 0.46-0.66, P < 0.001), but not PFS (HR 0.93, 95% CI 0.79-1.10, P = 0.349). Increased time spent in recommended follow-up according to EANO guidelines was associated with longer OS (HR 0.54, 95% CI 0.45-0.63, P < 0.001) but not PFS (HR 0.99, 95% CI 0.84-1.16, P = 0.874). CONCLUSION: Regular surveillance follow-up for glioblastoma is associated with longer OS. Prospective trials are needed to determine whether regular or symptom-directed MRI influences outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85202087464&partnerID=8YFLogxK
U2 - 10.1007/s11060-024-04705-3
DO - 10.1007/s11060-024-04705-3
M3 - Article
SN - 0167-594X
VL - 169
SP - 517
EP - 529
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 3
ER -