Trends in surgical management of astrocytomas and other brain gliomas

In recent years, surgical treatment of cerebral gliomas has made significant technical advances (e.g. microsurgery and neuronavigation) and has also benefitted from improvement in diagnostic techniques and biopathology. Thanks to this progress, there has been a reduction in the surgical mortality and morbidity of highly malignant neoplasms such as glioblastoma multiforme and medulloblastoma, although there has not been any significant improvement in survival. On the other hand, for a specific group of circumscribed and resectable brain gliomas, modern neurosurgery is potentially curative in a high proportion of cases, even if the gliomas are located in deep and previously inaccessible brain regions. These "benign" variants of cerebral gliomas occur mainly in children and young adults, i.e., in subjects with a long life-expectancy. Astrocytoma, oligodendroglioma and ependymoma are a third group of cerebral gliomas for which modern neurosurgery offers interesting new possibilities.