GLIOMA EXTENT OF RESECTION AND ITS IMPACT ON PATIENT OUTCOME : Neurosurgery (original) (raw)

REVIEW

Brain Tumor Research Center, Department of Neurological Surgery, University of California at San Francisco, San Francisco, California

Reprint requests: Nader Sanai, M.D., Department of Neurological Surgery, University of California at San Francisco, 300 Parnassus Avenue, M-779, Box 0112, San Francisco, CA 94143-0112. Email: [email protected]

Received, May 22, 2007.

Accepted, January 15, 2008.

Abstract

OBJECTIVE

There is still no general consensus in the literature regarding the role of extent of glioma resection in improving patient outcome. Although the importance of resection in obtaining tissue diagnosis and alleviating symptoms is clear, a lack of Class I evidence prevents similar certainty in assessing the influence of extent of resection.

METHODS

We reviewed every major clinical publication since 1990 on the role of extent of resection in glioma outcome.

RESULTS

Twenty-eight high-grade glioma articles and 10 low-grade glioma articles were examined in terms of quality of evidence, expected extent of resection, and survival benefit.

CONCLUSION

Despite persistent limitations in the quality of data, mounting evidence suggests that more extensive surgical resection is associated with longer life expectancy for both low- and high-grade gliomas.