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Improving surgical outcome for gliomas with intraoperative mapping
François-Xavier Ferracci1, Hugues Duffau2,3
1a Department of Neurosurgery , Rouen University Hospital , Rouen , France.
Expert Review of Neurotherapeutics
|March 10, 2018
Summary
Radical glioma resection improves survival, but preserving quality of life is key. Functional mapping-guided resection, using intraoperative stimulation, enhances tumor removal while protecting brain function and improving patient outcomes.
Area of Science:
- Neurosurgery
- Neuro-oncology
- Cognitive Neuroscience
Background:
- Glioma resection is vital for survival but must balance oncological goals with quality of life.
- Diffuse glioma infiltration and individual brain variability complicate surgical planning.
- Current functional neuroimaging lacks sufficient reliability for precise surgical guidance.
Purpose of the Study:
- To propose a shift towards functional mapping-guided glioma resection.
- To emphasize individualized cerebral mapping for optimizing surgical outcomes.
- To integrate cognitive neurosciences with glioma surgery.
Main Methods:
- Intraoperative electrical stimulation in awake patients with real-time cognitive monitoring.
- Individualized cerebral mapping focusing on dynamic cortico-subcortical circuits.
- Investigation of brain connectomics and neuroplastic potential.
Main Results:
- Functional mapping-guided resection increases the extent of glioma resection.
- This approach effectively spares eloquent neural networks.
- Improved oncological outcomes and enhanced quality of life are achieved.
Conclusions:
- Functional mapping-guided resection represents a paradigm shift in glioma surgery.
- Individualized connectomics and neuroplasticity assessment are crucial.
- Integrating cognitive neurosciences with surgical techniques improves both survival and quality of life.
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