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Is it all a matter of size? Impact of maximization of surgical resection in cerebral tumors

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Abstract

The oncological impact of cytoreductive surgery for malignant glioma has been analyzed in a few prospective, randomized studies; however, the impact of different cytoreductive surgical techniques of cerebral tumors remains controversial. Despite retrospective analyses revealing an oncological impact of complete surgical resection in cerebral metastases and low-grade glioma, the oncological impact of further extension of resection to a supramarginal resection remains disputable lacking high-grade evidence: supramarginal resections have yet to be analyzed in malignant glioma. Although extension of resection towards a supramarginal resection was thought to improve outcome and prevent malignant transformation in low-grade glioma, the rate of (temporary) deficits was higher than 50% in recent retrospective studies, and the oncological impact and long-term results have to be analyzed in further (prospective and controlled) studies. Cerebral metastases show a growth pattern different from glioma with less and more locally limited brain invasion. Therefore, local control may be achieved by extension of resection after complete lesionectomy of cerebral metastases. Therefore, supramarginal resection may be a promising approach but must be evaluated in further studies.

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  1. Marion Rapp and Michael Sabel contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany

    Marcel A. Kamp, Maxine Dibué-Adjei, Jan F. Cornelius, Philipp J. Slotty, Hans-Jakob Steiger, Sebastian A. Ahmadi, Marion Rapp & Michael Sabel

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Prof. Sabel is a consultant for Johnson & Johnson Company and Integra Company. Dr. Dibué-Adjei is an employee of LivaNova PLC, manufacturer of vagus nerve stimulators. All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interests; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Kamp, M.A., Dibué-Adjei, M., Cornelius, J. et al. Is it all a matter of size? Impact of maximization of surgical resection in cerebral tumors. Neurosurg Rev 42, 835–842 (2019). https://doi.org/10.1007/s10143-018-0963-z

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