1.The Dual Impact of Glioma Resection on Survival and Health-Related Quality of Life: Resect More, Live Better
Miguel ESQUIVEL-MIRANDA ; Dessiré GUTIÉRREZ-GUTIÉRREZ ; Emmanuelle VARGAS-VALENCIANO ; Allan RAMOS-ESQUIVEL ; Javeth CALVO-MOLINA ; Juan SAHUQUILLO-BARRIS
Brain Tumor Research and Treatment 2026;14(1):20-28
Background:
Health-related quality of life (HR-QoL) is a critical consideration in glioma surgery,alongside improving patient survival. Current evidence highlights maximal surgical resection as a key independent prognostic factor for enhancing HR-QoL and survivability. This study aimed to compare the impact on HR-QoL and survival rates in glioma patients before and after surgery with varying degrees of tumor resection (<10%, 10%–90%, >90%) and residual tumor volumes (≤2 cm 3 , >2 cm 3 ).
Methods:
This single-institution prospective study analyzed 117 patients with newly diagnosedgliomas (2009–2015). HR-QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) (global quality of life status [GQLS], physical, emotional, role, cognitive, and social function, as well as insomnia and fatigue).We compared survival rates and HR-QoL outcomes based on extent of resection and residual tumor volume. Clinically meaningful thresholds and statistical significance were used to evaluate HR-QoL changes.
Results:
In grade 4 gliomas, resections >90% and residual tumor volumes ≤2 cm 3 significantlyimproved median survival compared to lesser resections. For HR-QoL, resections >90% led to clinically and statistically significant improvements in GQLS, emotional, role, and cognitive function, as well as insomnia. Residual volumes ≤2 cm 3 significantly enhanced emotional and role function, with statistical improvements in GQLS, cognitive function, social function, insomnia, and fatigue. Lower resection rates and higher residual volumes resulted in significant HR-QoL declines. When stratified by tumor grade, high- and low-grade gliomas showed clinically significant improvements in different HR-QoL domains.
Conclusion
Resections greater than 90% and residual volumes ≤2 cm 3 significantly improve HR-QoL and overall survival. Conversely, partial resections and larger residual tumor volumes are associated with worse HR-QoL outcomes.

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