Advertisement

Neuro-Oncology pp 129-136 | Cite as

Surgery of Cerebral Gliomas: State of the Art

  • Pietro Paoletti
  • Giorgio Butti
  • Giovanni Spanu
Part of the Developments in Oncology book series (DION, volume 66)

Abstract

Generally, the first therapeutic approach in patients with cerebral gliomas is surgery. Technological advancements in both diagnosis and surgical instruments which have taken place in the past 20 years have greatly modified surgeons’ attitudes which have become more aggressive against this type of pathology. To define the state of the art in this field, the authors have taken into consideration the surgical cases at the Neurosurgical Institute of the University of Pavia from 1973 to 1989. During this period 339 adult supratentorial gliomas (125 glioblastomas, 115 anaplastic astrocytomas, 74 astrocytomas, and 25 other histotypes) were operated on. Patients were aged between 16 and 76 years. The overall surgical mortality was 4.7% which has decreased from 7% before 1980 to about 2% in the last ten years. Morbidity was 27.2% and has decreased significantly during the same period. The authors discuss pre- and postoperative pharmacological strategies, the usefulness of applying new diagnostic and surgical technology, the incidence of mortality and morbidity, time and quality of survival with respect to the different types of surgical operations.

Keywords

Malignant Glioma Anaplastic Astrocytoma Gross Total Resection Stereotactic Biopsy Cerebral Glioma 
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]
    Cushing, H.W. (1908) “Surgery of the head”, in W.W. Keen (ed.), Surgery: Its Principles and Practice, vol. 3, W.B. Saunders, Philadelphia, p. 231.Google Scholar
  2. 2]
    Paoletti, P., Spanu, G. (1990) “Surgical therapy of malignant gliomas”, J. Neurosurg. Sci., in press.Google Scholar
  3. 3]
    Paoletti, P., Robustelli della Cuna, G., Knerich, R. (1986) Manuale di Neuro-Oncologia Clinica, Masson, Milano.Google Scholar
  4. 4]
    Kornblith, P.L., Walker, M.D., Cassidy, J.R. (1987) Neurologic Oncology, Lippincot, Philadelphia.Google Scholar
  5. 5]
    Rosenblum, M.L., Berens, M.E., Rutka, J.T. (1989) “Recent perspectives in brain tumor biology and treatment”, Clin. Neurosurg., 37, 314–335.Google Scholar
  6. 6]
    Paoletti P. (1984) ”Therapeutic strategy for central nervous system tumors: present status, criticism and potential”, J. Neurosurg. Sci., 28, 51–60.PubMedGoogle Scholar
  7. 7]
    Suzuki, J. (1988) Treatment of Gliomas, Springer, Tokyo.CrossRefGoogle Scholar
  8. 8]
    Apuzzo, M.L.J. (1989) “Surgery of intracranial tumors: aspects of operating room design with integrator and use of technical adjuvants”, Clin Neurosurg., 37, 185–214.Google Scholar
  9. 9]
    Paoletti, P., Butti, G., Adinolfi, D., Assietti, R. (1989) “Surgical therapy for malignant gliomas”, Med. Biol. Envir., 17, 403–412.Google Scholar
  10. 10]
    Karim, A.B.M.F., Rutten, E.H.J.M., Gonzales, D.G., Punt, J., Van Glabbeke, M., Aaronson, N.K. (1985) “A randomized trial on the efficacy of radiation therapy of cerebral gliomas (low grade astrocytoma and oligodendroglioma) of the adult” EORTC protocol 22845.Google Scholar
  11. 11]
    Paoletti, P., Butti, G., Knerich, R., Gaetani, P., Assietti, R. (1990) “Chemotherapy for malignant gliomas of the brain: a review of ten-year experience”, Acta Neurochir., 103, 35–46.PubMedCrossRefGoogle Scholar
  12. 12]
    Fadul, C., Wood, J., Thaler, H., Galicich, J., Patterson, R.H. Jr., Posner, J.B. (1988) “Morbidity and mortality of craniotomy for excision of supratentorial gliomas”, Neurology, 38, 1374–1379.PubMedCrossRefGoogle Scholar
  13. 13]
    Guthrie, B.L., Laws, E.R. (1990) “Supratentorial low-grade gliomas”, in M.L. Rosenblum (ed.), The Role of Surgery in Brain Tumor Management, vol. 1, W.B. Saunders, Philadelphia, pp. 37–48.Google Scholar
  14. 14]
    Salcman M. (1990) “Malignant glioma management”, in Neurosurgery Clinics of North America, pp. 49–63.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1991

Authors and Affiliations

  • Pietro Paoletti
    • 1
  • Giorgio Butti
    • 1
  • Giovanni Spanu
    • 1
  1. 1.Department of Surgery - Neurosurgery and ”E Grossi-Paoletti” Center for the Study and Treatment of Nervous System TumorsUniversity of PaviaPaviaItaly

Personalised recommendations