多焦点/多中心脑胶质母细胞瘤（mGBM）占所有新诊断脑胶质母细胞瘤的20%。本研究探讨了细胞减少手术对mGBM患者生存和功能结果的影响。我们回顾性分析了2015年至2020年在作者所属机构接受手术治疗的71例新诊断的原发型（IDH1野生型）mGBM患者的临床和影像资料。多中心/多焦点生长的定义是指存在≥ 2个相距≥ 1cm的强化病灶。其中36例（50.7%）患者行了切除术，35例（49.3%）行了活检术。MGMT状态、年龄、术前KPI和NANO评分，以及术后KPI和NANO评分在切除术和活检术组之间没有显著差异。中位总生存期为6.4个月，与切除程度显著变化（强化病灶完全切除：13.6个月，STR：6.4个月，活检：3.4个月；P = 0.043）。切除术组中有21例（58.3%）行了放化疗，而活检术组中只有12例（34.3%）行了放化疗（p = 0.022）。多因素分析显示，化疗和放疗以及（尽管风险系数较小）切除程度（切除术 vs. 活检术）和多中心生长是患者生存的独立预测因子。涉及到功能脑区、神经功能缺失率和功能结果在活检术组和切除术组之间没有显著差异。在mGBM中进行切除手术与更好的生存相关。此益处似乎主要与更多患者能够耐受肿瘤切除后有效的辅助治疗有关。此外，细胞减少手术本身可能对生存有影响。© 2023年作者。

Multifocal/multicentric glioblastomas (mGBM) account for up to 20% of all newly diagnosed glioblastomas. The present study investigates the impact of cytoreductive surgery on survival and functional outcomes in patients with mGBM.We retrospectively reviewed clinical and imaging data of 71 patients with newly diagnosed primary (IDH1 wildtype) mGBM who underwent operative treatment in 2015-2020 at the authors' institution. Multicentric/multifocal growth was defined by the presence of ≥ 2 contrast enhancing lesions ≥ 1 cm apart from each other.36 (50.7%) patients had a resection and 35 (49.3%) a biopsy procedure. MGMT status, age, preoperative KPI and NANO scores as well as the postoperative KPI and NANO scores did not differ significantly between resected and biopsied cases. Median overall survival was 6.4 months and varied significantly with the extent of resection (complete resection of contrast enhancing tumor: 13.6, STR: 6.4, biopsy: 3.4 months; P = 0.043). 21 (58.3%) of resected vs. only 12 (34.3%) of biopsied cases had radiochemotherapy (p = 0.022). Multivariate analysis revealed chemo- and radiotherapy and also (albeit with smaller hazard ratios) extent of resection (resection vs. biopsy) and multicentric growth as independent predictors of patient survival. Involvement of eleoquent brain regions, as well as neurodeficit rates and functional outcomes did not vary significantly between the biopsy and the resection cohorts.Resective surgery in mGBM is associated with better survival. This benefit seems to relate prominently to an increased number of patients being able to tolerate effective adjuvant therapies after tumor resections. In addition, cytoreductive surgery may have a survival impact per se.© 2023. The Author(s).