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Journal of Neurosurgical Sciences 2021 October;65(5):524-31

DOI: 10.23736/S0390-5616.21.05277-2


lingua: Inglese

Longer survival of glioblastoma complicated by bacterial infections after surgery: what is known today

Alessio CHIAPPINI 1, 2 , Alejandro N. SANTOS 3, Ignazio DE TRIZIO 4, Davide CROCI 5, Luca VALCI 5, Michael REINERT 6, Francesco MARCHI 5

1 Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland; 2 Faculty of Medicine, University of Basel, Basel, Switzerland; 3 Department of Neurosurgery, University Hospital of Essen, Essen, Germany; 4 Department of Intensive Care Medicine, Regional Hospital of Lugano, Lugano, Switzerland; 5 Department of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland; 6 Department of Neurosurgery, Hirslanden Neurological and Spinal Surgery Center, St. Anna Clinic, Lucerne, Switzerland

INTRODUCTION: Glioblastoma is the most common primary brain tumor in adults with the worst overall survival. Post-craniotomy intracranial infections are not infrequent after surgery; however, their impact on overall survival of glioblastoma patients remains unclear. Here we report the case of an unusual longer survival of a glioblastoma patient affected by multiple infections and the review of the literature on this topic.
EVIDENCE ACQUISITION: PubMed, Embase and Cochrane search engines were reviewed for papers describing outcome of patients suffering from glioblastoma and associated cerebral infections.
EVIDENCE SYNTHESIS: Four papers accounting a total of 29 patients met the eligibility criteria. Staphylococcus aureus and Staphylococcus epidermidis resulted the most common bacteria causing post-craniotomy intracranial infections in brain tumor patients. The overall median survival rate was 18±18.12 months when adding all 29 patients. Only one study described a significant higher survival rate for the infected group.
CONCLUSIONS: Glioblastoma is the most frequent malignant brain tumor with a very poor outcome/survival. In the literature few cases described an exceptional longer survival often associated with a postoperative infection. To date, the pathophysiology behind this longer survival remains unclear, but it seems that Staphylococcus species could have an influence on the progression of this aggressive brain tumor.

KEY WORDS: Glioblastoma; Surgical wound infection; Survival rate

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