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Updated: May 8, 2026
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Published on: May 9, 2022
The role of supramaximal resection in glioblastoma: A review
Background:
Glioblastoma remains a significant challenge in neurosurgery, with no consensus on the optimal extent of resection beyond MRI contrast-enhancing regions. Nevertheless, several studies suggest that supramaximal resection may confer a prognostic advantage. This review aims to synthesize the existing evidence on this topic.
Methods:
A narrative review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [1]. The PubMed, ScienceDirect and Embase databases were searched using the keywords "glioblastoma AND (supramaximal OR supratotal OR extended resection OR FLAIR resection/FLAIRectomy OR lobectomy OR functional lobectomy OR resection beyond enhancement)". The search was performed on January 24th, 2026.
Results:
A total of 64 studies were included, predominantly small retrospective series that employed various techniques to achieve supramaximal resection, including awake surgery, fluorescein-guided resection, and lobectomy. Despite variations in the definition of supramaximal resection, most studies consistently reported a survival advantage for patients whose resection extended beyond the contrast-enhancing tumor.
Conclusion:
Supramaximal resection (SMR) in glioblastoma (GB) is gaining interest and significantly improves overall and progression-free survival, but its definition remains challenging, and data on patients' postoperative quality of life and neurological status remain limited.
