[Surgical Management of Glioblastoma:Evolving with Advances in Surgical Support Technologies]

Glioblastoma is the most common and aggressive primary brain tumor. Despite advances in multimodal treatment, including surgery, radiotherapy, and temozolomide-based chemotherapy, the prognosis remains poor. Surgical resection plays a central role in glioblastoma management, with the primary objective of achieving maximal safe resection by maximizing tumor removal while preserving neurological function. Recent advances in surgical support technologies have substantially improved the safety and efficacy of glioblastoma surgery. Neuronavigation, tractography, intraoperative neurophysiological monitoring, awake mapping, and 5-aminolevulinic acid fluorescence-guided surgery enable surgeons to accurately visualize tumor boundaries and critical functional structures. Furthermore, emerging technologies, including augmented reality, image enhancement systems, and rapid intraoperative molecular diagnostics, provide additional anatomical and biological information that may facilitate precise surgical decision-making. This review summarizes the principles of glioblastoma surgery and discusses the recent innovations in surgical support technologies. The integration of anatomical, functional, vascular, and molecular information is transforming glioblastoma surgery into a more sophisticated form of information-guided surgery, with the goal of improving both oncological and functional outcomes.