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Emerging Concepts in Neuro-Oncology pp 143–159Cite as

Surgical Management of Glial Cancers

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Abstract

The value of surgery for low- and high-grade gliomas alike has long been debated due to the lack of randomized controlled data. Recent studies are providing more and more insight into different benefits derived from surgery and in particular the value extensive cytoreduction in both low- and high-grade gliomas, even in the elderly with malignant gliomas. However, there is ample evidence indicating that prevention of neurological deficits is paramount to radicality.

A plethora of intraoperative methods are available to maximize radicality while minimizing the risks for neurological deficits. These methods should be used judiciously and as a complement to immaculate surgical technique and an intimate familiarity with neuroanatomy.

Nevertheless, not many general recommendations can be made regarding resectability of individual tumors, since the decision of how far to reduce tumor burden depends on many factors, including surgical experience, availability of surgical adjuncts, and patient preference. If extensive cytoreduction is the aim of surgery, technical adjuncts should be used as much as possible, even in high-grade gliomas.

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  1. Department of Neurosurgery, University of Münster, Albert-Schweitzer Campus 1A, Munster, 48161, Germany

    Walter Stummer

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  1. , Department of Clinical Neurosciences, University of Cambridge, Hills Road, Cambridge, CB2 0QQ, United Kingdom

    Colin Watts

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Stummer, W. (2013). Surgical Management of Glial Cancers. In: Watts, C. (eds) Emerging Concepts in Neuro-Oncology. Springer, London. https://doi.org/10.1007/978-0-85729-458-6_9

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