Advertisement

The Current Status of Radical Resection for Gliomas

  • Elizabeth M Mutisya
  • Mitchel S Berger

In the United States, the incidence of intracranial tumors is 4.5 per 100,000 population. Primary neoplasms account for the majority of intracran'ial tumors in most series, approximately half of which are gliomas. Although the optimal treatment for these tumors remains widely debated, recent studies reveal improved survival rates and better seizure control with radical resection, supporting the role of this approach in the management of gliomas. Several techniques, many new, facilitate maximum resection while minimizing morbidity. These include frameless and framebased stereotaxy, intraoperative ultrasonography, optical imaging, electrocorticography, functional mapping, functional magnetic resonance imaging, magnetoencephalography, and Wada testing. Radical resection may bicurative for some low-grade gliomas, and it is used in conjunction . with adjuvant irradiation or chemotherapy in the treatment of malignant lesions.

Keywords

Malignant Glioma Radical Resection Functional Magnetic Resonance Imaging Intractable Epilepsy Functional Mapping 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Okazaki H: Neoplastic and related lesions. In Fundamentals of Neuropathology. Edited by Okazaki H. New York: Igaku-Shoin; 1989:203–274.Google Scholar
  2. 2.
    Ammirati M, Vick N, Liao Y, et al.: Effect of extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic strocy-tomas.Neurosurgery1987, 21:201–206.PubMedCrossRefGoogle Scholar
  3. 3.
    Hollerhage HG, Zumkeller M, Becker M, et al.: Influence of type and extent of surgery on early results and survival time in glioblastoma multifome.Acta Neurochir1991, 113:31–37.CrossRefGoogle Scholar
  4. 4.
    Salcman M: Supratentorial gliomas: Clinical features and surgical therapy.Neurosurgery. Edited by Wilkins RH, Rengachery SS. New York: McGraw-Hill; 1985:579–590.Google Scholar
  5. 5.
    Tel E, Hoshino T, Barker M, et al.: Effect of surgery on BCNU chemotherapy in a rat brain tumor model. J Neurosurg1980, 52:529–532.PubMedCrossRefGoogle Scholar
  6. 6.
    Tarbell NJ, Loeffler JS: Recent trends in the radiotherapy of pediatric gliomas.J Neurooncol1996, 28:233–244.PubMedCrossRefGoogle Scholar
  7. 7.
    Iacoangoli M, Roselli R, Prezuono A, et al.: Staging of supratentorial hemispheric glioma using tumour extension, histopathological grade and extent of surgial resection.Br J Surg1993, 80:1130–1133.CrossRefGoogle Scholar
  8. 8.
    Kimmel DW, O'Fallon JR, Scheithauer BW, et al.: Prognostic value of cytogenetic analysis in human cerebral astrocytomas.Ann Neurol1992, 31:534–542.PubMedCrossRefGoogle Scholar
  9. 9.
    Shaw EG, Scheithauer BW, O'Fallon JR, et al.: Mixed oligodendrogliomas: A survival and prognostic factor analysis.Neurosurgery1994, 34:577–582.PubMedCrossRefGoogle Scholar
  10. 10.
    Walker NM, Green SB, Byar DP, et al.: Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery.N Engl J Med1980, 303:1323–1329.PubMedCrossRefGoogle Scholar
  11. 11.
    Hoshino T, Rodriguez LA, Cho KG, et al.: Prognostic implications of the proliferative potential of low-grade astrocytomas.J Neurosurg1988, 69:839–842.PubMedCrossRefGoogle Scholar
  12. 12.
    Prados MD, Krouwer HGJ, Edwards MSB, et al.: Proliferative potential and outcome in pediatric astrocytic tumors.J Neurooncol1992, 13:277–282.PubMedCrossRefGoogle Scholar
  13. 13.
    Berger MS, Ghatan S, Haglund MM, et al.: Low grade gliomas associated with intractable epilepsy: Seizure outcome utilizing electrocorticography during tumor resection.J Neurosurg1993, 79:62–69.PubMedCrossRefGoogle Scholar
  14. 14.
    Soffietti R, Chio A, Giordana MT, et al.: Prognostic factors in well-differentiated cerebral astrocytomas in the adult.Neurosurgery1989, 24:686–692.PubMedCrossRefGoogle Scholar
  15. 15.
    Laws ER, Taylor WF, Bergstralh EJ, et al.: The neurosurgical management of low-grade astrocytitoma.Clin Neuro-surg1985, 33:575–588.Google Scholar
  16. 16.
    North CA, North RB, Epstein JA et al.: Low-grade astrocytomas: Survival and quality of life after radiation therapy.Cancer1990, 66:6–14.PubMedCrossRefGoogle Scholar
  17. 17.
    Caimcross JG, Lapierriere NJ: Low-grade glioma: To treat or not to treat?Arch Neurol1989, 46:1238–1239.CrossRefGoogle Scholar
  18. 18.
    Recht LD, Lew R, Smith TW: Suspected low-grade glioma: Is deferring treatment safe?Ann Neurol1992, 31:431–436.PubMedCrossRefGoogle Scholar
  19. 19.
    Berger MS, Deliganis AV, Dobbins J, Keles GE: The effect of extent of resection on recurrence in patients with low-grade cerebral hemisphere gliomas.Cancer1994, 74:1784–1791.PubMedCrossRefGoogle Scholar
  20. 20.
    Leibel SA, Sheline GE, Wara WM, et al.: The role of radiation therapy in the treatment of astrocytomas.Cancer 1975, 35:1151–1157.CrossRefGoogle Scholar
  21. 21.
    Lindegaard K-F, Mørk SJ, Eide GE, et al.: Statistical analysis of clinicopathological features, radiotherapy, and survival in 170 cases of oligodendroglioma.J Neurosurg1987, 67:224–230.PubMedCrossRefGoogle Scholar
  22. 22.
    Philippon JH, Clemenceau SH, Fauchon JF: Supratentorial low-grade astrocytoma in adults.Neurusrgery1993, 32:554–559.CrossRefGoogle Scholar
  23. 23.
    Hirsch JF, Sainte Rose C, Pierre-Khan A, et al.: Benign astrocytic and oligodendrocytic tumors of the cerebral hemispheres in children.J Neurosurg1989, 70:568–572.PubMedCrossRefGoogle Scholar
  24. 24.
    Shaw EG, Daumas-Duport C, Scheithauer BW, et al.: Radiation therapy in the management of low-grade supratentorial astrocytomas. J Neurosurg 1989:70:853–861.PubMedCrossRefGoogle Scholar
  25. 25.
    Miralbell R, Balart J, Matias-Guiu X, et al.: Radiotherapy for supratentorial low-grade gliomas: Results and prognostic factors with special focus on tumour volume parameters.Radiother Oncol1993, 27:112–116.PubMedCrossRefGoogle Scholar
  26. 26.
    Scerrati M, Roselli R, Iacoangeli M, et al.: Prognostic factors in low grade (WHO grade II) gliomas of the cerebral hemispheres: The role of surgery.J Neurol Neurosurg Psychiatry1996, 61:291–296.PubMedCrossRefGoogle Scholar
  27. 27.
    Goldring S, Rich KM, Picker S: Experience with gliomas in patients presenting with a chronic seizure disorder.Clin Neurosurg1986, 33:15.Google Scholar
  28. 28.
    Balestrini MR, Zanette M, Micheli R, et al.: Hemispheric cerebral tumors in children. Long-term prognosis concerning survival rate and quality of life: Considerations on a series of 64 cases operated upon.Childs Nerv Syst1990, 6:143–147.PubMedCrossRefGoogle Scholar
  29. 29.
    Bloom HJG, Glees J, Bell J: The treatment and long-term prognosis of children with intracranial tumors: A study of 610 cases, 1950–1981.Int J Radiat Oncol Biol Phys1990, 18:723–745.PubMedCrossRefGoogle Scholar
  30. 30.
    Pollack IF, Claassen D, al-Shbout Q, et al.: Low-grade gliomas of the cerebral hemispheres in children: An analysis of 71 cases.J Neurosurg1995, 82:536–547.PubMedCrossRefGoogle Scholar
  31. 31.
    Hoffman HJ, Solomuk DS, Humphreys RP, et al.: Management and outcome of low-grade astrocytomas of the midline in children: A retrospective review.Neurosurgery1993, 33:964–971.PubMedCrossRefGoogle Scholar
  32. 32.
    Epstein FJ, Wisoff JH: Brainstem tumors in childhood: Surgical indications. InPediatric Neurosurgery of the Developing Nervous System. Edited by McLaurin RL, Schut I, Venes JL, et al.: Philadelphia: WB Saunders; 1989:357–365.Google Scholar
  33. 33.
    Epstein F, Epstein N: Surgical treatment of spinal cord astrocytomas of childhood: A series of 19 patients.J Neurosurg1982, 57:685–689.PubMedCrossRefGoogle Scholar
  34. 34.
    Stroink AR, Hoffman HJ, Hendrick EB, et al.: Diagnosis and management of pediatric brain-stem gliomas.J Neurosurg1986, 65:745–750.PubMedCrossRefGoogle Scholar
  35. 35.
    Garcia DM, Fulling KH, Marks JE: The value of radiation therapy in addition to surgery for astrocytomas of the adult cerebrum.Cancer1985, 55:919–927.PubMedCrossRefGoogle Scholar
  36. 36.
    Al-Mefty O, Kersch JE, Routh A, et al.: The long-term side effects of radiation therapy for benign brain tumors in adults.J Neurosurg1990, 73:502–512.PubMedCrossRefGoogle Scholar
  37. 37.
    Devaux BC, O'Fallon JR, Kelly PJ: Resection, biopsy, and survival in malignant glial neoplasms: A retrospective study of clinical parameters, therapy, and outcome.J Neurosurg1993, 78:767–775.PubMedCrossRefGoogle Scholar
  38. 38.
    Quigley MR, Flores N, Maroon JC, etal.: Value of surgical intervention in the treatment of glioma.Stereotact Funct Neurosurg1995, 65:171–175.PubMedCrossRefGoogle Scholar
  39. 39.
    Kiwit JC, Floeth FW, Bock VVJ: Survival in malignant glioma: Analysis of prognostic factors with special regard to cytoreductive surgery.Zentralbl Neurochir1996, 57:76–88.PubMedGoogle Scholar
  40. 40.
    Cohadon F, Aouad NB, Rougier A, etal.: Histologic and non-histologic factors correlated with survival time in suporatentorial astrocytic tumors.J Neurooncol1985, 3:105–111.PubMedCrossRefGoogle Scholar
  41. 41.
    Nelson DF, Nelson JS, Davis DR, etal.: Survival and prognosis of patients with astrocytoma with atypical or anaplastic features.J Neurooncol1985, 3:99–103.PubMedCrossRefGoogle Scholar
  42. 42.
    Wood JR, Green SB, Shapiro WR: The prognostic importance of tumor size in malignant gliomas: A computed tomographic scan study by the Brain Tumor Cooperative Group.J Clin Oncol1988, 6:338–343.PubMedGoogle Scholar
  43. 43.
    Kelly PJ, Daumas-Duport C, Kispart DB, etal.: Imaging-based stereotactic serial biopsies in untreated intracranial glial neoplasms.J Neurosurg1987, 66:865–874.PubMedCrossRefGoogle Scholar
  44. 44.
    Silbergeld DL, Chicoine MR: Isolation and characteriza-tion of human malignant gliomas cells from histologically normal brain.J Neurosurg1997, 86:525–531.PubMedCrossRefGoogle Scholar
  45. 45.
    Scharfen CO, Sneed PK, Wara WM, etal.: High activity iodine-125 implant for gliomas.Int J Radiat Oncol Biol Phys1992, 24:583–591.PubMedCrossRefGoogle Scholar
  46. 46.
    Shrieve DC, Alexander E III, Wen PY, etal.: Comparison of stereotactic radiosurgery and brachytherapy in the treatment of recurrent glioblastoma multiforme.Neurosurgery1995, 36:275–284.PubMedCrossRefGoogle Scholar
  47. 47.
    Packer RJ, Lange B, Ater J, etal.: Carboplatin and vin-cristine for recurrent and newly diagnosed low-grade gliomas of childhood.J Clin Oncol1983, 11:850–856.Google Scholar
  48. 48.
    Petronio J, Edwards MSB, Prados M, et al.: Management of chiasmal and hypothalamic gliomas of infancy and childhood with chemotherapy.J Neurosurg1991, 74:701–708.PubMedCrossRefGoogle Scholar
  49. 49.
    Souweidane NM, Hoffman HJ: Current treatment of thal-amic gliomas in children.J Neurooncol1996, 28:157–166.PubMedCrossRefGoogle Scholar
  50. 50.
    Weiner HL, Kelly PJ: A novel computer-assisted volumetric stereotactic approach for resecting tumors of the posterior parahippocampal gyms.J Neurosurg1996, 85:272–277.PubMedCrossRefGoogle Scholar
  51. 51.
    Smith KA, Spetzler RF: Supratentorial-infraoccipital approach for posteromedial temporal lobe lesions. J Neurosurg 1995, 82:940–944.PubMedCrossRefGoogle Scholar
  52. 52.
    Hammond MA, Ligon BL, el Souki R, etal.: Use of intra-operative ultrasound for localizing tumors and determining the extent of resection: A comparative study with magnetic resonance imaging.J Neurosurg1996, 84:737–741.CrossRefGoogle Scholar
  53. 53.
    LeRoux PD, Winter TC, Berger MS, et al.: A comparison between preoperative magnetic resonance scans and intraoperative ultrasound tumor volumes and margins.J Clin Ultrasound1994, 22:29–36.CrossRefGoogle Scholar
  54. 54.
    Haglund MM, Berger MS, Hochman DW: Enhanced optical imaging of human gliomas and tumor margins.Neurosurgery1996, 38:308–317.PubMedCrossRefGoogle Scholar
  55. 55.
    Berger MS, Kincaid J, Ojemann GA, Lettich, E: Brain mapping techniques to maximize resection, safety, and seizure control in children with brain tumors.Neurosurgery1989, 25:786–792.PubMedCrossRefGoogle Scholar
  56. 56.
    Skirboll SS, Ojemann GA, Berger MS, et al.: Functional cortex and subcortical white matter located within grossly infiltrative tumors.Neurosurgery1996, 38:678–685.PubMedCrossRefGoogle Scholar
  57. 57.
    Berger MS, Ojemann GA: Techniques for functional brain mapping during glioma surgery. InThe Gliomas. Edited by Berger MS. Philadelphia: WB Saunders; 1998, in press.Google Scholar
  58. 58.
    Anderson SW, Damasio H, Tranel D: Neuropsychological impairments associated with lesions caused by tumor or stroke.Arch Neurol1990, 47:397–405.CrossRefGoogle Scholar
  59. 59.
    Ojemann JG, Miller JW, Silbergeld DL: Preserved function in brain invaded by tumor.Neurosurgery1996, 39:253–259.PubMedCrossRefGoogle Scholar
  60. 60.
    Kelly PJ: Volumetric stereotactic surgical resection of intra-axial brain mass lesions.Mayo Clin Proc1988, 63:1186–1198.PubMedGoogle Scholar
  61. 61.
    Drake J, Hoffman HJ, Kobayashi, et al.: Surgical management of children with temporal lobe epilepsy and mass lesions.Neurosurgery1987, 21:792–797.PubMedCrossRefGoogle Scholar
  62. 62.
    Berger MS, Ghatan S, Geyer JR, et al.: Seizure outcome in children with hemispheric tumors and associated intractable epilepsy: The role of tumor removal combined with seizure foci resection.Pediatr Neurosurg1992, 17:185–191.CrossRefGoogle Scholar
  63. 63.
    Cooper PR, Epstein F: Radical resection of intramedullary spinal cord tumors in adults.J Neurosurg1985, 63:492–499.PubMedCrossRefGoogle Scholar
  64. 64.
    Berger MS: Functional mapping guided resection of low grade gliomas.Clin Neurosurg1995, 42:437–452.PubMedGoogle Scholar
  65. 65.
    Berger MS, Ojemann GA: Techniques of functional localization during removal of tumors involving the cerebral hemispheres. InIntraoperative Monitoring Techniques in Neurosurgery. Edited by Loftus C, Traynelis V. New York: McGraw-Hill; 1994:113–127.Google Scholar
  66. 66.
    Binder JR, Rao SM, Hammeke TA, et al.: Functional magnetic resonance imaging of human auditory cortex.Ann Neurol1994, 35:662–672.PubMedCrossRefGoogle Scholar
  67. 67.
    Blamire AM, Ogawa S, Ugurbil K, et al.: Dynamic mapping of the human visual cortex by high-speed magnetic resonance imaging.Proc Nall Acad Sci USA1992, 89:11069–11073.CrossRefGoogle Scholar
  68. 68.
    Kim S-G, Ashe J, Hendrich K, et al.: Functional magnetic resonance imaging of motor cortex: Hemispheric asymmetry and handedness.Science1993, 261:615–617.PubMedCrossRefGoogle Scholar
  69. 69.
    Ogawa S, Tank DW, Menon R, et al.: Intrinsic signal changes accompanying sensory stimulation: Functional brain mapping wit magnetic resonance imaging.Proc Natl Acad Sci USA1992,89:5951–5955.PubMedCrossRefGoogle Scholar
  70. 70.
    Jack CR Jr, Thompson RM, Butts RK, et al.: Sensory motor cortex: Correlation of presurgical mapping with functional MR imaging and invasive cortical mapping.Radiology1994, 190:85–92.Google Scholar
  71. 71.
    Mueller WM, Yetkin FZ, Hammeke TA, et al.: Functional magnetic resonance imaging mapping of the motor cortex in patients with cerebral tumors.Neurosurgery1996, 39:515–521.PubMedGoogle Scholar
  72. 72.
    Puce A, Constable RT, Luby ML, et al.: Functional magnetic resonance imaging of sensory and motor cortex: Comparison with electrophysiological localization.J Neurosurg1995, 83:262–270.PubMedCrossRefGoogle Scholar
  73. 73.
    Mogilner A, Grossman JA, Ribury U, et al.: Somatosensory cortical plasticity in adult humans revealed by magnetoencephalography.Proc Nall Acad Sci USA1993, 90:3593–3597.CrossRefGoogle Scholar
  74. 74.
    Rezai AR, Hund M, Kronberg E, et al.: The interactive use of magnetoencephalography in stereotactic image-guided neurosurgery.Neurosurgery1996, 39:92–102.PubMedCrossRefGoogle Scholar
  75. 75.
    Sobel DF, Gallen CC, Schwartz BJ, et al.: Locating the central sulcus: comparison of MR anatomic and magnetoencephalographic functional methods.AJNR1993, 14:915–925.PubMedGoogle Scholar
  76. 76.
    Fox PT, Burton H, Raichle ME: Mapping human somatosensory cortex with positron emission tomography.J Neurosurgery1987, 67:34–43.CrossRefGoogle Scholar
  77. 77.
    Metter EJ, Wasterlain CG, Kuhl DE, et al.: FDG positron emission computed tomography in a study of aphasia.Ann Neurol1981, 10:173–183.PubMedCrossRefGoogle Scholar
  78. 78.
    Pardo JV, Fox PT: Preoperative assessment of the cerebral hemispheric dominance for language with CBF PET.Hum Brain Mapping1993, 1:57–68CrossRefGoogle Scholar
  79. 79.
    Wada J, Rasmussan T: Intracarotid injections of sodium amytal for the lateralization of cerebral speech dominance. JNeurosurg1960, 17:266–282.CrossRefGoogle Scholar

Copyright information

© Current Medicine, Inc. 1998

Authors and Affiliations

  • Elizabeth M Mutisya
  • Mitchel S Berger

There are no affiliations available

Personalised recommendations