Gliomas in adults.
BACKGROUND
Primary brain tumors are among the ten most common causes of cancer-related death. There is no screening test for them, but timely diagnosis and treatment improve the outcome. Ideally, treatment should be provided in a highly specialized center, but patients reach such centers only on the referral of their primary care physicians or other medical specialists from a wide variety of fields. An up-to-date account of basic knowledge in this area would thus seem desirable, as recent years have seen major developments both in the scientific understanding of these tumors and in clinical methods of diagnosis and treatment.


METHODS
Selective search of the pertinent literature (PubMed and Cochrane Library), including the guidelines of the German Societies of Neurosurgery, Neurology, and Radiotherapy.


CONCLUSIONS
Modern neuroradiological imaging, in particular magnetic resonance imaging, can show structural lesions at high resolution and provide a variety of biological and functional information, yet it is still no substitute for histological diagnosis. Gross total resection of gliomas significantly improves overall survival. New molecular markers can be used for prognostication. Chemotherapy plays a major role in the treatment of various different kinds of glioma. The median survival, however, generally remains poor, e.g., 14.6 months for glio-blastoma.
Klinik für Neurochirurgie, Otto-von-Guericke Universität Magdeburg, Magdeburg, Germany. thomas.schneider@med.ovgu.de
Thomas
T
Schneider
Christian
C
Mawrin
Cordula
C
Scherlach
Martin
M
Skalej
Raimund
R
Firsching
D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002465:Cell Movement / Q000502:physiology; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005910:Glioma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D011379:Prognosis; D016019:Survival Analysis