最大程度的肿瘤切除可提高胶质母细胞瘤患者的总生存期（OS）。切除范围（EOR）在历史上是二分法的。 RANO 切除小组最近提出了对根据 Stupp 方案治疗的患者进行基于容量的 EOR 评估的标准。本研究的目的是 (1) 调查 EOR 对接受洛莫司汀 (CCNU)/替莫唑胺 (TMZ) 联合化疗的患者的预后价值，以及 (2) 分析二元 EOR 评估与容量评估相比的预后表现。本研究纳入了 78 例新诊断的 MGMT 甲基化 GBM 患者，接受肿瘤切除术，随后接受 CCNU/TMZ 放化疗。测量第一次切除后的残余对比增强 (CE) 肿瘤体积，并使用单变量和多变量 Cox 回归分析以及双边对数秩检验分析其对 OS 和 PFS 的影响。根据 RANO 切除组提出的标准，将患者分为 RTV ≤1 cm3、>1 cm3 - ≤5 cm3 和 >5 cm3。 OS 延长与年龄 <60 岁、低 RTV 和大体全切除 (GTR) 相关。与二元 EOR 评估相比，残余肿瘤体积 (RTV) 具有更高的预后价值。完全或接近完全切除 CE 肿瘤（≤ 1 cm³ RTV）的患者显示 OS 延长（中位 54.4 个月，95% CI 46.94 - 未达到），5 年生存率为 49%。低 RTV 与增加相关接受 CCNU/TMZ 放化疗的胶质母细胞瘤患者的生存率。这项研究证明了最近提出的 RANO 切除标准在该亚组患者中的适用性。© 作者 2024。由牛津大学出版社代表神经肿瘤学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限都可以通过我们网站文章页面上的权限链接通过我们的 RightsLink 服务获得 - 如需了解更多信息，请联系journals.permissions@oup.com。

Maximum tumor resection improves overall survival (OS) in patients with glioblastoma. The extent of resection (EOR) is historically dichotomized. The RANO resect group recently proposed criteria for volumetry-based EOR assessment in patients that were treated according to Stupp´s protocol. The purpose of this study was (1) to investigate the prognostic value of EOR in patients receiving combined chemotherapy with lomustine (CCNU)/temozolomide (TMZ), and (2) to analyse the prognostic performance of binary EOR assessment compared to volumetric assessment.78 patients with newly diagnosed MGMT-methylated GBM undergoing tumor resection followed by radiochemotherapy with CCNU/TMZ were included in this study. Residual contrast-enhancing (CE) tumor volume after the first resection was measured and its influence on OS and PFS was analysed using uni- and multivariable Cox regression analysis as well as two-sided log rank test. Patients were divided into RTV ≤1 cm³, >1 cm³ - ≤5 cm³ and >5 cm³ following the proposed criteria of the RANO resect group.Prolonged OS was associated with age <60 years, low RTV, and gross total resection (GTR). Residual tumor volume (RTV) had a superior prognostic value compared to binary EOR assessment. Patients with total or near total resection of CE tumor (≤1 cm³ RTV) showed prolonged OS (median 54.4 months, 95% CI 46.94-not reached), with a 5-year survival rate of 49%.Low RTV is associated with increased survival in glioblastoma patients undergoing radiochemotherapy with CCNU/TMZ. This study demonstrates the applicability of the recently proposed RANO resect criteria in this subgroup of patients.© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.