Surgical Management of Intracranial Gliomas — Does Radical Resection Improve Outcome?

  • E. R. Laws
  • M. E. Shaffrey
  • A. Morris
  • F. A. AndersonJr
Part of the Acta Neurochirurgica Supplements book series (NEUROCHIRURGICA, volume 85)

Abstract

This paper discusses the arguments for and against radical tumor resection as a strategy for treatment of cerebral gliomas.

Method. Data from the Glioma Outcome Project were analyzed to determine whether survival could be related to extent of resection in 666 patients treated by biopsy or resection for malignant cerebral gliomas.

Findings. Consistent survival advantages were noted for those patients treated with resection.

Interpretation. This observational study, although undoubtedly reflecting selection bias, provides data that support resection as a major factor in survival after surgery for malignant gliomas.

Keywords

Malignant glioma Glioblastoma Outcome survival 

References

  1. 1.
    Anderson FA Jr, The Gliomas Outcomes Project Advisory Board (1998) The Glioma Outcomes Project: a resource for measuring and improving glioma outcomes. Neurosurg Focus 4(6): 8–10CrossRefGoogle Scholar
  2. 2.
    Ciric I, Ammirati M, Vick N, Mikhael M (1987) Supratentorial gliomas: surgical considerations and immediate postoperative results. Neurosurgery 21: 21–26PubMedCrossRefGoogle Scholar
  3. 3.
    Curran WJ Jr, Scott CB, Horton J, Nelson JS, Weinstein AS, Fischbach AJ, Chang CH, Rothman M, Asbell SO, Krisch RE et al (1993) Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Nat Cancer Inst 85: 704–710PubMedCrossRefGoogle Scholar
  4. 4.
    Kelly PJ, Daumàs-Duport C, Kispert DB, Kall BA, Scheithauer BW, Illig JJ (1987) Imaging-based stereotactic serial biopsies in untreated intracranial glial neoplasms. J Neurosurg 66: 865–874PubMedCrossRefGoogle Scholar
  5. 5.
    Kreth FW, Berlis A, Spiropoulou V, Faist M, Scheremet R, Rossner R, Volk B, Ostertag CB (1999) The role of tumor resection in the treatment of glioblastoma multiforme in adults. Cancer 86: 2117–2123PubMedCrossRefGoogle Scholar
  6. 6.
    Laws ER, Goldberg WJ, Bernstein JJ (1993) Migration of human malignant astrocytoma cells in the mammalian brain: Scherer revisted. Int J Devl Neurosci 11: 691–697CrossRefGoogle Scholar
  7. 7.
    Laws ER, Shaffrey ME (1999) The inherent invasiveness of cerebral gliomas: implications for clinical management. Int J Devl Neurosci 17: 413–420CrossRefGoogle Scholar
  8. 8.
    Laws ER Jr, Taylor WF, Clifton MB, Okagaki H (1984) Neurosurgical management of low-grade astrocytomas of the cerebral hemispheres. J Neurosurg 61: 665–673PubMedCrossRefGoogle Scholar
  9. 9.
    Ojemann JG, Miller JW, Silbergeld DL (1996) Preserved func tion in brain invaded by tumor. Neurosurgery 39: 253–259PubMedCrossRefGoogle Scholar
  10. 10.
    Silbergeld DL, Chicone MR (1997) Isolation of human malignant glioma cells from histologically normal brain. J Neurosurg 86: 525–531PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 2003

Authors and Affiliations

  • E. R. Laws
    • 1
  • M. E. Shaffrey
    • 1
  • A. Morris
    • 1
  • F. A. AndersonJr
    • 2
  1. 1.Department of NeurosurgeryHealth Science Centre, University of Charlottesville VirginiaUSA
  2. 2.Center for Outcomes ResearchUniversity of Massachusetts Medical SchoolWorcesterUSA

Personalised recommendations