Surgical Management and Advances in the Treatment of Glioma

Hardigan, Andrew A. MD, PhD
Jackson, Joshua D. MD, PhD
Patel, Anoop P. MD

¹Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina

Address for correspondence Anoop P. Patel, MD, Department of Neurosurgery, Duke University Medical Center, Durham, NC 27705 (e-mail: [email protected])

Conflict of Interest

None declared.

Issue Theme Neuro-oncology: Guest Editors: Lynne P. Taylor, MD, FAAN, Tresa M. McGranahan, MD, PhD, and Vyshak Alva Venur, MD

article published online November 14, 2023

Seminars in Neurology 43(6):p 810-824, December 2023. | DOI: 10.1055/s-0043-1776766

Abstract

The care of patients with both high-grade glioma and low-grade glioma necessitates an interdisciplinary collaboration between neurosurgeons, neuro-oncologists, neurologists and other practitioners. In this review, we aim to detail the considerations, approaches and advances in the neurosurgical care of gliomas. We describe the impact of extent-of-resection in high-grade and low-grade glioma, with particular focus on primary and recurrent glioblastoma. We address advances in surgical methods and adjunct technologies such as intraoperative imaging and fluorescence guided surgery that maximize extent-of-resection while minimizing the potential for iatrogenic neurological deficits. Finally, we review surgically-mediated therapies other than resection and discuss the role of neurosurgery in emerging paradigm-shifts in inter-disciplinary glioma management such as serial tissue sampling and “window of opportunity trials”.