{"id":10451,"date":"2026-01-29T12:40:22","date_gmt":"2026-01-29T11:40:22","guid":{"rendered":"https:\/\/neurohirurgija.in.rs\/?page_id=10451"},"modified":"2026-06-18T06:05:08","modified_gmt":"2026-06-18T04:05:08","slug":"glioblastoma-gbm","status":"publish","type":"page","link":"https:\/\/neurohirurgija.in.rs\/en\/glioblastoma-gbm\/","title":{"rendered":"Glioblastoma (GBM) \u2014 Symptoms, Diagnosis, Surgery, and Modern Treatment"},"content":{"rendered":"\n
\n
\n Author:<\/span>\n \n Dr. Zeljko Kojadinovic, MD, PhD\n <\/a>\n \u2014 Consultant Neurosurgeon\n <\/div>\n\n
\n Specialized Experience:<\/span>\n 30 years of clinical expertise in neurosurgery.\n <\/div>\n\n
\n Last medically reviewed:<\/span>\n January 28, 2026\n <\/div>\n<\/div>\n\n\n\n
\n
\n

Who This Glioblastoma (GBM) Page Is For<\/h3>\n <\/div>\n\n

\n This page is intended for patients diagnosed with glioblastoma (GBM), as well as for family members and caregivers who are seeking a clear, structured explanation of the disease and its treatment options.\n <\/p>\n\n

\n Readers are not expected to read this page from start to finish. Instead, you may return to different sections as the disease progresses \u2014 when treatment decisions arise, MRI findings become unclear, or new questions appear at later stages.\n <\/p>\n\n

\n If recommendations differ, surgery is described as high risk or not indicated, post-treatment MRI findings are ambiguous (tumor recurrence vs. radiation necrosis), or you are unsure what surgery can realistically achieve in your specific situation, an individualized\n \n neurosurgical second opinion\n <\/a>\n can help clarify options and outline a realistic strategic path forward.\n <\/p>\n<\/div>\n\n\n\n

\n \n
\n When patients and families seek a second opinion for glioblastoma (GBM)\n <\/div>\n\n
\n
\u2022 The diagnosis feels overwhelming or difficult to understand<\/div>\n
\u2022 Surgery is described as high risk or not recommended<\/div>\n
\u2022 It is unclear why surgery, biopsy, or only radiochemotherapy is proposed<\/div>\n
\u2022 MRI findings after treatment raise questions about recurrence or radiation necrosis<\/div>\n
\u2022 Prognosis and further treatment options are not clearly explained<\/div>\n
\u2022 An independent, expert evaluation is needed regarding clinical trials or emerging treatment alternatives to ensure they are scientifically sound and safe for the patient<\/div>\n\n <\/div>\n\n
\n In glioblastoma care, seeking an independent expert opinion is a common and responsible step.\n If this reflects your situation, you may request an individualized neurosurgical review here:\n \n Request Second Opinion\n <\/a>\n <\/div>\n\n<\/div>\n\n\n\n
\n

\n Glioblastoma (GBM) \u2014 Quick Summary (Read This First)\n <\/h3>\n\n
    \n
  • Glioblastoma (GBM) is the most aggressive primary malignant brain tumor in adults.<\/strong> It grows diffusely, meaning tumor cells spread microscopically into surrounding brain tissue beyond what is visible on MRI.<\/li>\n\n
  • GBM is classified as CNS WHO grade 4.<\/strong> The most common form is IDH-wildtype glioblastoma, which behaves aggressively and usually appears suddenly rather than evolving slowly over years.<\/li>\n\n
  • \nOnce the diagnosis of glioblastoma (GBM) is confirmed, surgery alone can almost never cure the disease.<\/strong>\nEven when all visible tumor is removed, microscopic tumor cells remain infiltrating the surrounding brain tissue.\nSurgery is therefore aimed at reducing tumor burden, relieving intracranial pressure, and preserving neurological function,\nwhile additional treatments are required to address residual disease.\n<\/li>\n\n\n
  • MRI with contrast is the key diagnostic test.<\/strong> The enhancing \u201ccore\u201d seen on MRI represents only part of the tumor; invisible infiltrative cells extend beyond it like a fog.<\/li>\n\n
  • Standard treatment combines surgery (when feasible), radiotherapy, and chemotherapy with Temozolomide.<\/strong> Radiation is typically delivered as 60 Gy over 6 weeks, with chemotherapy given during and after radiation.<\/li>\n\n
  • Not all patients are candidates for surgery.<\/strong> Decisions depend on tumor location, neurological function, and the Karnofsky Performance Status (KPS), which reflects the patient\u2019s ability to care for themselves.<\/li>\n\n
  • Recurrence is common.<\/strong> New MRI changes after treatment may represent tumor recurrence or radiation injury (radiation necrosis), which can be difficult to distinguish.<\/li>\n\n
  • Overall prognosis is limited.<\/strong> Median survival is approximately 12\u201315 months, but outcomes vary depending on age, functional status, extent of resection, and molecular markers such as MGMT promoter methylation.<\/li>\n\n
  • This page is structured so you can read only what matters to you.<\/strong> Use the Contents box to jump to sections on diagnosis, surgery, radiotherapy, recurrence, or prognosis.<\/li>\n <\/ul>\n<\/div>\n\n

    \n Most readers benefit from the Quick Summary plus the sections on Treatment<\/strong>, Why Surgery Is Sometimes Not Recommended<\/strong>, and Prognosis<\/strong>. The remaining sections provide deeper understanding.\n<\/p>\n\n\n\n