Watts C, Price S J, Santarius T
University of Cambridge, Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK; Department of Clinical Neurosciences, Cambridge Centre for Brain Repair, University of Cambridge, Cambridge, UK.
University of Cambridge, Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK.
Clin Oncol (R Coll Radiol). 2014 Jul;26(7):385-94. doi: 10.1016/j.clon.2014.04.001. Epub 2014 Jun 2.
The scientific basis for the surgical management of patients with glioma is rapidly evolving. The infiltrative nature of these cancers precludes a surgical cure, but despite this, cytoreductive surgery remains central to high-quality patient care. In addition to tissue sampling for accurate histopathological diagnosis and molecular genetic characterisation, clinical benefit from decompression of space-occupying lesions and microsurgical cytoreduction has been reported in patients with different grades of glioma. By integrating advanced surgical techniques with molecular genetic characterisation of the disease and targeted radiotherapy and chemotherapy, it is possible to construct a programme of personalised surgical therapy throughout the patient journey. The goal of therapeutic packages tailored to each patient is to optimise patient safety and clinical outcome and must be delivered in a multidisciplinary setting. Here we review the current concepts that underlie surgical subspecialisation in the management of patients with glioma.
胶质瘤患者手术治疗的科学依据正在迅速发展。这些癌症的浸润性使得手术无法治愈，但尽管如此，减瘤手术仍然是高质量患者护理的核心。除了进行组织采样以获得准确的组织病理学诊断和分子遗传学特征外，不同分级的胶质瘤患者通过占位性病变减压和显微手术减瘤也已报告有临床获益。通过将先进的手术技术与疾病的分子遗传学特征以及靶向放疗和化疗相结合，有可能在患者整个病程中构建个性化手术治疗方案。针对每位患者量身定制的治疗方案的目标是优化患者安全性和临床结局，并且必须在多学科环境中实施。在此，我们综述了胶质瘤患者管理中手术亚专业的当前基础概念。
