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Pushing the boundaries of neurosurgical oncology: evaluating the superiority of supratotal resection over gross total resection in intraoperative MRI-guided glioma surgery.

作者信息

Mirzayeva Leyla Salimli, Uçar Murat, Budak Sümeyye Nur, Kaymaz Ahmet Memduh, Yaylı Nezih

机构信息

Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey.

Hacettepe University Department of Public Health, Ankara, Turkey.

出版信息

Neurosurg Rev. 2025 Feb 6;48(1):200. doi: 10.1007/s10143-025-03301-x.


DOI:10.1007/s10143-025-03301-x
PMID:39909935
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11799004/
Abstract

Using intraoperative MRI (iMRI) in glioma surgery can enhance the extent of resection (EOR) and improve survival rates for patients diagnosed with low grade gliomas (LGG) or high grade gliomas (HGG). This study focused on patients who underwent iMRI-guided surgery for LGG and HGG at our center. Our objective was to compare the patient survival time and recurrence rate between supratotal resection (SpTR) and gross total resection(GTR). To the best of our knowledge, this is the first study comparing SpTR with GTR using iMRI in glioma surgery. This study included 71 patients who had undergone iMRI-guided GTR and SpTR. The volume of the tumors was measured using postcontrast 3D T1W series and 3D FLAIR series taken the day before surgery, and the volume of the operation cavity was calculated from iMRI images. The effects of SpTR and GTR on overall and progression-free survival (OS and PFS) were analyzed by the log-rank test using Kaplan‒Meier curves. The associations between the extent of resection and tumor grade, and between recurrence and tumor grade were examined using the chi-square test. The rate of recurrence in patients diagnosed with HGG was greater than that in patients diagnosed with LGG (p = 0.022). While patients who received SpTR had a greater OS time (105.9 months) than did those who underwent GTR (92.8 months), the difference was not statistically significant. The patients with LGG had a significantly longer PFS time than did the patients with HGG (86.5 ± 5.9 months, 95% CI = 74.9-98.2, p < 0.0001). Of 23 patients diagnosed with HGG, SpTR was achieved in 9 and GTR was achieved in 14. The median OS time was longer in patients who underwent SpTR than in those who underwent GTR, but there was no statistically significant difference [101.2 ± 20.5 months (95% CI: 80.7-121.7) vs. 70.6 ± 9.9 (95% CI: 60.7-80.5) p = 0.9]. Neurosurgeons are increasingly choosing SpTR, especially in LGGs. Despite their slow growth, LGGs retain the potential for malignant transformation. This situation underscores the importance of maximum safe resection in the surgery of LGGs. iMRI-guided resection makes it easier for surgeons to show the EOR concurrent with the operation.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5484/11799004/ab996296f006/10143_2025_3301_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5484/11799004/8a417636388b/10143_2025_3301_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5484/11799004/612e76517fa7/10143_2025_3301_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5484/11799004/ab996296f006/10143_2025_3301_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5484/11799004/8a417636388b/10143_2025_3301_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5484/11799004/612e76517fa7/10143_2025_3301_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5484/11799004/ab996296f006/10143_2025_3301_Fig3_HTML.jpg

相似文献

[1]
Pushing the boundaries of neurosurgical oncology: evaluating the superiority of supratotal resection over gross total resection in intraoperative MRI-guided glioma surgery.

Neurosurg Rev. 2025-2-6

[2]
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[10]
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引用本文的文献

[1]
Advances of MR imaging in glioma: what the neurosurgeon needs to know.

Acta Neurochir (Wien). 2025-6-21

本文引用的文献

[1]
The oncological role of resection in newly diagnosed diffuse adult-type glioma defined by the WHO 2021 classification: a Review by the RANO resect group.

Lancet Oncol. 2024-9

[2]
Intraoperative magnetic resonance imaging in glioma surgery: a single-center experience.

J Neurooncol. 2024-6

[3]
Supratotal Resection: An Emerging Concept of Glioblastoma Multiforme Surgery-Systematic Review And Meta-Analysis.

World Neurosurg. 2023-11

[4]
Supratotal Surgical Resection for Low-Grade Glioma: A Systematic Review.

Cancers (Basel). 2023-4-26

[5]
Supratotal Resection of Glioblastoma: Better Survival Outcome than Gross Total Resection.

J Pers Med. 2023-2-22

[6]
Supratotal Resection of Gliomas With Awake Brain Mapping: Maximal Tumor Resection Preserving Motor, Language, and Neurocognitive Functions.

Front Neurol. 2022-5-12

[7]
Oncological and functional outcomes of supratotal resection of IDH1 wild-type glioblastoma based on C-methionine PET: a retrospective, single-center study.

Sci Rep. 2021-7-15

[8]
Neuropsychological outcomes following supratotal resection for high-grade glioma: a review.

J Neurooncol. 2021-5

[9]
Role of molecular biomarkers in glioma resection: a systematic review.

Chin Neurosurg J. 2020-5-18

[10]
Resection of tumors within the primary motor cortex using high-frequency stimulation: oncological and functional efficiency of this versatile approach based on clinical conditions.

J Neurosurg. 2019-8-9

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