6533b85efe1ef96bd12c0775

RESEARCH PRODUCT

Brain Mapping-Aided SupraTotal Resection (SpTR) of Brain Tumors: The Role of Brain Connectivity

Francesca GrazianoLara BrunassoMaria Angela PinoRosa Maria GerardiFederica PaoliniGiuseppe Emmanuele UmanaRosario MaugeriCarlo GulìRoberta CostanzoCesare GagliardoPaola FeracoMassimo MidiriDomenico Gerardo IacopinoLuigi BasileDomenico MessinaSilvana TumbioloGiuseppe Roberto GiammalvaGianluca Scalia

subject

Cancer ResearchConnectomicsmedicine.medical_specialtyMini Reviewlow-grade gliomasBrain tumorbrain connectomelcsh:RC254-282Brain mappingResectionLesionWhite matterNeuroimagingmedicineBrain connectome Supratotal resection Brain mapping Brain tumor Connectomics Extent of resection High-grade gliomas Low-grade GliomasconnectomicsBrain GliomaSettore MED/27 - Neurochirurgiabusiness.industryAstrocytomalcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogensmedicine.diseaseextent of resectionmedicine.anatomical_structureOncologySuprtotal resectionbrain mappingRadiologymedicine.symptomsupratotal resectionbusinesshigh-grade gliomasbrain tumorMRI

description

Brain gliomas require a deep knowledge of their effects on brain connectivity. Understanding the complex relationship between tumor and functional brain is the preliminary and fundamental step for the subsequent surgery. The extent of resection (EOR) is an independent variable of surgical effectiveness and it correlates with the overall survival. Until now, great efforts have been made to achieve gross total resection (GTR) as the standard of care of brain tumor patients. However, high and low-grade gliomas have an infiltrative behavior and peritumoral white matter is often infiltrated by tumoral cells. According to these evidences, many efforts have been made to push the boundary of the resection beyond the contrast-enhanced lesion core on T1w MRI, in the so called supratotal resection (SpTR). SpTR is aimed to maximize the extent of resection and thus the overall survival. SpTR of primary brain tumors is a feasible technique and its safety is improved by intraoperative neuromonitoring and advanced neuroimaging. Only transient cognitive impairments have been reported in SpTR patients compared to GTR patients. Moreover, SpTR is related to a longer overall and progression-free survival along with preserving neuro-cognitive functions and quality of life.

yearjournalcountryeditionlanguage
2021-03-02
10.3389/fonc.2021.645854https://hdl.handle.net/11585/812378