Novel Surgical Approaches to High-Grade Gliomas.

作者: Fahid Tariq Rasul , Colin Watts

DOI: 10.1007/S11940-015-0369-Y

关键词: MedicineRadiation therapyNeuronavigationNeurosurgeryProgression-free survivalDebulkingMicrosurgerySurgeryPerformance statusGlioma

摘要: Treatment of patients with high-grade glioma (HGG) should begin thorough evaluation by a specialized multidisciplinary team to determine whether or not the patient is appropriate for surgery, chemotherapy and radiotherapy. Particular attention be paid performance status neurological function. Surgery first step in therapeutic intervention. Patients undergo either biopsy, debulking surgery maximal resection depending on anatomical location tumour patient’s clinical condition. Extent has prognostic value. In who are ‘fit surgery’, aim remove all contrast-enhancing without causing deficit. If microsurgical feasible, then open stereotactic, performed confirm diagnosis perform molecular genetic analyses (MGMT methylation status, loss heterozygosity 1p/19q, IDH1 status) as this treatment implications. Over past decade, much research focussed novel surgical approaches improve long-term outcomes. The evidence support benefit maximizing extent growing. Advances neurosurgical techniques allow safer, more aggressive maximize whilst minimizing Surgical adjuncts including advanced neuronavigation, intraoperative magnetic resonance imaging, high-frequency ultrasonography, fluorescence-guided microsurgery using fluorescence, functional mapping motor language pathways, locally delivered therapies extending armamentarium neurosurgeon provide best outcome. Operating elderly those recurrent disease, although controversial, becoming common due emerging approaches. Here, we discuss comment future HGG surgery.

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