Awake Glioma Surgery with Intraoperative Mapping: Predictors of Language Outcome and Survival

Area of Science:

• Neurosurgery
• Neuro-oncology
• Neurolinguistics

Background:

• Awake craniotomy with intraoperative mapping is standard for gliomas in language areas.
• It aims to maximize tumor resection while preserving function.
• This study sought predictors of language decline and survival after awake surgery for malignant glioma.

Purpose of the Study:

• Identify clinical and intraoperative predictors of postoperative language worsening.
• Determine factors influencing overall survival in patients undergoing awake glioma surgery.

Main Methods:

• Retrospective multicenter cohort study of 37 patients with dominant hemisphere malignant glioma.
• Analysis of clinical, radiological, intraoperative, and postoperative variables.
• Logistic and Cox regression models used to analyze language outcomes and survival.

Main Results:

• 16.2% of patients experienced postoperative language worsening.
• Increasing age was associated with higher odds of language worsening (OR 1.12/year).
• Increasing age (HR 1.10) and WHO grade 4 (HR 18.15) predicted shorter overall survival.

Conclusions:

• Awake glioma surgery with mapping yielded favorable language outcomes in most patients at 3 months.
• Increasing age is a potential predictor of postoperative language worsening.
• Findings are exploratory due to small sample size; larger studies are needed.