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Published on: August 12, 2019
Surgical treatment for glioma: extent of resection applying functional neurosurgery
Nobuhiro Mikuni1, Susumu Miyamoto
1Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Kyoto, Japan. mikunin@kuhp.kyoto-u.ac.jp
Abstract:
Current treatments for gliomas, including surgery, chemotherapy, and radiation therapy, frequently result in unsuccessful outcomes. Studies on glioma resection were reviewed to assess better treatment outcomes applying the newest neurosurgical multimodalities. We reviewed reports of surgical removal of gliomas utilizing functional brain mapping, monitoring, and other functional neurosurgery techniques such as neuronavigation and awake surgery. Attempts to maximize the extent of glioma resection improved survival. A close proximity of the resection to the eloquent areas increased the risk of perioperative neurological deficits. However, those deficits often improved during the postoperative rehabilitation and recovery period when the essential or the compensative eloquent areas remained intact. Pre- and intraoperative application of the latest brain function analysis methods promoted safe elimination of gliomas. These methods are expected to help explore the long-term prognosis of glioma treatment and the mechanism for recovery from functional disabilities.
Insights
Maximizing glioma resection extent using advanced neurosurgical techniques improves survival. Functional brain mapping and awake surgery help achieve safe glioma removal, aiding recovery from neurological deficits.
Area of Science:
- Neurosurgery
- Oncology
- Neuroscience
Background:
- Current glioma treatments (surgery, chemotherapy, radiation) often yield poor outcomes.
- Gliomas pose significant challenges due to their location and potential for neurological deficits.
Purpose of the Study:
- To review and assess the impact of modern neurosurgical multimodalities on glioma resection outcomes.
- To evaluate the role of advanced functional neurosurgery techniques in improving patient survival and recovery.
Main Methods:
- Systematic review of studies on glioma resection.
- Analysis of techniques including functional brain mapping, intraoperative monitoring, neuronavigation, and awake surgery.
Main Results:
- Maximizing the extent of glioma resection is associated with improved survival rates.
- Proximity to eloquent areas increases perioperative neurological deficit risk, but deficits often improve with rehabilitation.
- Advanced pre- and intraoperative brain function analysis facilitates safe glioma removal.
Conclusions:
- Modern neurosurgical techniques enhance the safety and efficacy of glioma resection.
- Functional brain analysis methods are crucial for optimizing glioma treatment and understanding recovery mechanisms.
