Retrospective analysis of clinical impact of biopsy preceding resection in surgically-accessible glioblastoma

Aggressive resection in surgically-accessible glioblastoma (GBM) correlates with improved survival over less extensive resections. However, the clinical impact of performing a biospy before definitive resection is not clear. Analysis of National Cancer Database information on 17,334 GBM patients from 2010-2014 found that upfront resection resulted in superior overall survival compared with biopsy followed by resection (median OS 12.4 versus 11.1 months; p=0.001). Similarly, multivariable accelerated failure time models favored upfront resection over biopsy followed by resection (time ratio 0.83; p=0.001). Upfront resection versus biopsy followed by resection was associated with 73% decreased 30-day mortality and 44% decreased 90-day mortality (p<0.001). The authors conclude that pre-operative biopsies for surgically-accessible GBM are associated with worse survival compared with upfront resection.