Optimizing outcomes with maximal surgical resection of malignant gliomas.
BACKGROUND
Aggressive surgical resection of malignant gliomas is a controversial issue in neurosurgery. Studies with rigorous methodology that fully address this issue have only recently become available.


METHODS
The controversy regarding the role of maximal surgical resection of malignant gliomas is reviewed. The authors discuss surgical techniques and adjunctive technologies that can be utilized to assist in resection of these lesions.


RESULTS
Using current microneurosurgical techniques, it is possible to resect malignant gliomas in gross total fashion. An aggressive approach in which 98% or more of the tumor mass is resected results in a statistically significant survival advantage.


CONCLUSIONS
An aggressive surgical procedure for malignant gliomas can result in increased survival duration for selected groups of patients.
Hentschel
Stephen J
SJ
Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Sawaya
Raymond
R
D001932:Brain Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005910:Glioma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures; D016896:Treatment Outcome