[The role of surgery in the treatment of glial tumors].

Indications for surgery in the management of glial tumors is twofold. Surgery provides a pathology-based diagnosis that is mandatory in every patient with a clinical diagnosis of glial tumor. However, its role in duration of survival is controversial. Total surgical removal is the best prognostic factor in grade 1 glioma. For grade 2 to 4 gliomas, the results of surgery are variable. Surgical resection is undoubtedly associated with clinical improvement. Its impact on duration of survival is not firmly established, due to, on the one hand, the infiltrative pattern of these types of tumors and, on the other hand, to the inherent difficulty in evaluating their size either pre- or postoperatively. However, the sole clinical improvement related to surgical resection appears sufficient to justify patients' exposure to resective surgery. The surgical risk has dramatically decreased over the last few years mainly due to technical improvements.