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01-12-2019 | Review

Is it all a matter of size? Impact of maximization of surgical resection in cerebral tumors

Authors: Marcel A. Kamp, Maxine Dibué-Adjei, Jan F. Cornelius, Philipp J. Slotty, Hans-Jakob Steiger, Sebastian A. Ahmadi, Marion Rapp, Michael Sabel

Published in: Neurosurgical Review | Issue 4/2019

Abstract

The oncological impact of cytoreductive surgery for malignant glioma has been analyzed in a few prospective, randomized studies; however, the impact of different cytoreductive surgical techniques of cerebral tumors remains controversial. Despite retrospective analyses revealing an oncological impact of complete surgical resection in cerebral metastases and low-grade glioma, the oncological impact of further extension of resection to a supramarginal resection remains disputable lacking high-grade evidence: supramarginal resections have yet to be analyzed in malignant glioma. Although extension of resection towards a supramarginal resection was thought to improve outcome and prevent malignant transformation in low-grade glioma, the rate of (temporary) deficits was higher than 50% in recent retrospective studies, and the oncological impact and long-term results have to be analyzed in further (prospective and controlled) studies. Cerebral metastases show a growth pattern different from glioma with less and more locally limited brain invasion. Therefore, local control may be achieved by extension of resection after complete lesionectomy of cerebral metastases. Therefore, supramarginal resection may be a promising approach but must be evaluated in further studies.

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Title: Is it all a matter of size? Impact of maximization of surgical resection in cerebral tumors
Authors: Marcel A. Kamp
Maxine Dibué-Adjei
Jan F. Cornelius
Philipp J. Slotty
Hans-Jakob Steiger
Sebastian A. Ahmadi
Marion Rapp
Michael Sabel
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Published in: Neurosurgical Review / Issue 4/2019
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-018-0963-z

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Is it all a matter of size? Impact of maximization of surgical resection in cerebral tumors

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