Abstract:

Glioblastoma multiforme (GBM) is the most frequent primary central nervous system (CNS) tumor. Despite the best treatment and advances in therapy, prognosis remains poor. One of the mainstays of therapy in GBM is surgical excision. Several studies have confirmed that the extent of resection (EOR) positively influences overall survival (OS) in patients with high-grade gliomas (HGGs). A literature search was performed using PubMed to assess the useful neurosurgical tools to achieve the best neurosurgical performance. In order to achieve the major extent of resection, preserving neurological function, many tools are now available, especially neuronavigation, intraoperative fluorescence, intraoperative ultrasound, and neuromonitoring. In addition to the maximal excision of tumor, the neurosurgeon can use photodynamic therapy (PTD) and local drug delivery (LDD) to improve the local control and bridge conventional radio and chemotherapy. EOR improves OS in patients with HGGs. There are technological possibilities for achieving a complete resection preserving neurological function, and it is not acceptable to perform only biopsy of these lesions.

Authors:

Roberto Altieri, MD, Resident in Neurosurgery, Section of Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy, Marco Maria Fontanella, MD, Professor of Neurosurgery, Department of Neurosurgery, Spedali Civili di Brescia, Brescia, Italy, Giannantonio Spena, MD, Francesco Zenga, MD, Specialist in Neurosurgery, Fabio Cofano, MD, Resident in Neurosurgery, Alessandro Agnoletti, MD, Resident in Neurosurgery, Emanuela Crobeddu, MD, Resident in Neurosurgery, Riccardo Fornaro, MD, Specialist in Neurosurgery, Alessandro Ducati, MD, Professor of Neurosurgery, Diego Garbossa, MD, Specialist in Neurosurgery

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