Surgical Management and Advances in the Treatment of Glioma

Semin Neurol. 2023 Dec;43(6):810-824. doi: 10.1055/s-0043-1776766. Epub 2023 Nov 14.

Abstract

The care of patients with both high-grade glioma and low-grade glioma necessitates an interdisciplinary collaboration between neurosurgeons, neuro-oncologists, neurologists and other practitioners. In this review, we aim to detail the considerations, approaches and advances in the neurosurgical care of gliomas. We describe the impact of extent-of-resection in high-grade and low-grade glioma, with particular focus on primary and recurrent glioblastoma. We address advances in surgical methods and adjunct technologies such as intraoperative imaging and fluorescence guided surgery that maximize extent-of-resection while minimizing the potential for iatrogenic neurological deficits. Finally, we review surgically-mediated therapies other than resection and discuss the role of neurosurgery in emerging paradigm-shifts in inter-disciplinary glioma management such as serial tissue sampling and "window of opportunity trials".

Publication types

  • Review

MeSH terms

  • Brain Neoplasms* / surgery
  • Glioma* / surgery
  • Humans
  • Neoplasm Recurrence, Local / surgery
  • Neurosurgical Procedures
  • Surgery, Computer-Assisted* / methods