Glioma Surgery: How Routine is Supratotal Resection?

Hasan Çağlar UĞURa , Eyüp BAYATLIa

aAnkara University Faculty of Medicine, Department of Neurosurgery, Ankara, Türkiye

Uğur HÇ, Bayatlı E. Glioma surgery: How routine is supratotal resection? In: Uğur HÇ, Bayatlı E, eds. Glial Tumours: Expectations from Today-Promises of the Future. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.38-41.

ABSTRACT

Maximal safe resection and survival have been found to be significantly related. Maximal safe surgical resection has become the main surgical goal in glioma surgery. In this regard, surgical re- section involving relatively less involved brain tissues, defined as Supratotal (SpTR) or supramaximal resection, has come to the fore. It is known that SpTR will significantly increase survival in both low- grade and high-grade glioma cases. For the future, the definition of SpTR should be standardized and gen- eral acceptance of the technical limits of the resection in question should be ensured. In addition, patients who underwent SpTR in large randomized series, free from bias, need to be evaluated in detail in terms of tumor location, molecular profile and surgical adjuncts used. Provided that the quality of life is pre- served, in other words, provided that the onco-functional balance is maintained, the concept of SpTR is a candidate for surgical routine in selected cases.

Keywords: Glioma; surgical treatment; maximal resection; safe resection; supratotal resection

Referanslar

  1. Louis DN, Perry A, Wesseling P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol. 2021;23(8):1231-51. [Crossref]  [PubMed]  [PMC]
  2. Lacroix M, Abi-Said D, Fourney DR, et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg. 2001;95(2):190-8. [Crossref]  [PubMed]
  3. Mohile NA, Messersmith H, Gatson NT, et al. Therapy for diffuse astro- cytic and oligodendroglial tumors in adults: ASCO-SNO guideline. J Clin Oncol. 2022;40(4):403-26. [Crossref]  [PubMed]
  4. Wen PY, Weller M, Lee EQ, et al. Glioblastoma in adults: a Society for Neuro-Oncology (SNO) and European Society of Neuro-Oncology (EANO) consensus review on current management and future directions. Neuro Oncol. 2020;22(8):1073-113. [PubMed]
  5. Rakovec M, Khalafallah AM, Wei O, Day D, Sheehan JP, Sherman JH, et al. A consensus definition of supratotal resection for anatomically distinct primary glioblastoma: an AANS/CNS Section on Tumors survey of neurosurgical oncologists. J Neurooncol. 2022;159(2):233-42. [Crossref]  [PubMed]
  6. Grabowski MM, Recinos PF, Nowacki AS, et al. Residual tumor volume versus extent of resection: predictors of survival after surgery for glio- blastoma. J Neurosurg. 2014;121(5):1115-23. [Crossref]  [PubMed]
  7. Kotrotsou A, Elakkad A, Sun J, et al. Multi-center study finds postopera- tive residual non-enhancing component of glioblastoma as a new deter- minant of patient outcome. J Neurooncol. 2018;139(1):125-33. [Crossref]  [PubMed]
  8. Li YM, Suki D, Hess K, Sawaya R. The influence of maximum safe resec- tion of glioblastoma on survival in 1229 patients: can we do better than gross-total resection? J Neurosurg. 2016;124(4):977-88. [Crossref]  [PubMed]
  9. Karschnia P, Young JS, Dono A, et al. Prognostic validation of a new classification system for extent of resection in glioblastoma: a report of the RANO resect group. Neuro Oncol. 2022;25(5):940-54. [PubMed]
  10. Duffau H. Long-term outcomes after supratotal resection of diffuse low-grade Gliomas: a consecutive series with 11-year follow-up. Acta Neurochir. 2016;158:51-8. [Crossref]  [PubMed]
  11. Jackson C, Choi J, Khalafallah AM, et al. A systematic review and meta-analysis of supratotal versus gross total resection for glioblastoma. J Neurooncol. 2020;148(3):419-31. [Crossref]  [PubMed]
  12. Khalafallah AM, Huq S, Jimenez AE, Serra R, Bettegowda C, Mukherjee D. "zooming in" on glioblastoma: understanding tumor heterogeneity and its clinical implications in the era of single-cell ribonucleic acid sequencing. Neurosurgery. 2021;88(3):477-86. [Crossref]  [PubMed]
  13. Petrecca K, Guiot MC, Panet-Raymond V, Souhami L. Failure pattern following complete resection plus radiotherapy and temozolomide is at the resection margin in patients with glioblastoma. J Neurooncol. 2013;111(1):19-23. [Crossref]  [PubMed]
  14. Karschnia P, Vogelbaum MA, Van Den Bent M, et al. Evidence-based re- commendations on categories for extent of resection in diffuse glioma. Eur J Cancer. 2021;149:23-33. [Crossref]  [PubMed]
  15. Gay L, Rossi M, Conti Nibali M, Sciortino T, Bello L. Rate and type of recurrence of lower-grade gliomas submitted to functional neurosurgical approach: the impact of the extent of resection. Neuro Oncol. 2022;24(Supplement_2):ii17-ii17. [Crossref]  [PMC]
  16. Kommers IO, Eijgelaar RS, Barkhof F, et al. When to resect or biopsy for patients with supratentorial glioblastoma: a multivariable prediction model. Neuro Oncol. 2022;24(Supplement_2):ii65-ii6. [Crossref]  [PMC]
  17. Aabedi AA, Young JS, Zhang Y, et al. Association of neurological im- pairment on the relative benefit of maximal extent of resection in chemoradiation-treated newly diagnosed isocitrate dehydrogenase wild-type glioblastoma. Neurosurgery. 2022;90(1):124-30. [Crossref]  [PubMed]  [PMC]
  18. Young JS, Morshed RA, Gogos AJ, et al. The glioma-network interface: a review of the relationship between glioma molecular subtype and intratumoral function. Neurosurgery. 2020;87(6):1078-84. [Crossref]  [PubMed]  [PMC]
  19. De Witt Hamer PC, Robles SG, Zwinderman AH, Duffau H, Berger MS. Impact of intraoperative stimulation brain mapping on glioma surgery outcome: a meta-analysis. J Clin Oncol. 2012;30(20):2559-65. [Crossref]  [PubMed]
  20. Moiraghi A, Prada F, Delaidelli A, et al. Navigated intraoperative 2-dimensional ultrasound in high-grade glioma surgery: impact on extent of resection and patient outcome. Oper Neurosurg. 2020;18(4):363-73. [Crossref]  [PubMed]
  21. Neira JA, Ung TH, Sims JS, et al. Aggressive resection at the infiltrative margins of glioblastoma facilitated by intraoperative fluorescein guid- ance. J Neurosurg. 2017;127(1):111-22. [Crossref]  [PubMed]
  22. Stummer W, Pichlmeier U, Meinel T, ve ark; ALA-Glioma Study Group. Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol. 2006;7(5):392-401. [Crossref]  [PubMed]
  23. Golub D, Hyde J, Dogra S, et al. Intraoperative MRI versus 5-ALA in high-grade glioma resection: a network meta-analysis. J Neurosurg. 2020;134(2):484-98. [Crossref]  [PubMed]
  24. Shah AH, Mahavadi A, Di L, Sanjurjo A, Eichberg DG, Borowy V, et al. Survival benefit of lobectomy for glioblastoma: moving towards radical supramaximal resection. J Neurooncol. 2020;148:501-8. [Crossref]  [PubMed]  [PMC]
  25. Yordanova YN, Moritz-Gasser S, Duffau H. Awake surgery for who Grade II Gliomas within "Noneloquent" areas in the left dominant hemisphere: toward a "Supratotal" resection. Clinical Article. J Neurosurg. 2011;115:232-9. [Crossref]  [PubMed]
  26. Wann A, Tully PA, Barnes EH, et al. Outcomes after second surgery for re- current glioblastoma: a retrospective case-control study. J Neurooncol. 2018;137(2):409-15. [Crossref]  [PubMed]
  27. Rossi M, Ambrogi F, Gay L, Gallucci M, Conti Nibali M, Leonetti A, et al. Is supratotal resection achievable in low-grade gliomas? Feasibility, putative factors, safety, and functional outcome. J Neurosurg. 2019;132(6):1692-705. [Crossref]  [PubMed]
  28. Yordanova YN, Duffau H. Supratotal resection of diffuse gliomas - an overview of its multifaceted implications. Neurochirurgie. 2017;63(3):243-9. [Crossref]  [PubMed]
  29. Ng S, Herbet G, Moritz-Gasser S, Duffau H. Return to Work Following Surgery for Incidental Diffuse Low-Grade Glioma: A Prospective Series With 74 Patients. Neurosurgery. 2020;87(4):720-9. [Crossref]  [PubMed]