Neurosurgical Management of Gliomas

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 1394

Special Issue Editor


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Guest Editor
1. Department of Neurosurgery, CHU Lille, F-59000 Lille, France
2. INSERM, CHU-Lille, U1189-ONCOTHAI-Assisted Laser Therapy and Immunotherapy for Oncology, Université de Lille, F-59000 Lille, France
Interests: intraoperative MRI; fluorescence-guided surgery; photodynamic therapy

Special Issue Information

Dear Colleagues,

Neurosurgical management plays a critical role in the treatment of gliomas, which are tumors that arise from the glial cells in the brain.  The primary objective of neurosurgical intervention is to safely remove as much of the tumor as possible while preserving neurological function.

The management of gliomas involves a multidisciplinary approach, with neurosurgeons, oncologists, radiologists, and other specialists working together to develop an individualized treatment plan for each patient.

Surgery is often the first-line treatment for gliomas, aiming to achieve maximal safe resection. Moreover it provides material for the histo-molecular analysis of the tumor leading to the best medical management. The extent of tumor removal depends on various factors, such as the tumor location, size, and proximity to vital brain structures and may require different tools as intraoperative monitoring in awake condition, intraoperative imaging or fluorescence-guided surgery.  The goal is to remove as much of the tumor as possible to alleviate symptoms, reduce tumor burden, and potentially improve patient outcomes.  

This special issue hopes to provide some implications for future clinical practice by exploring the neurosurgical management of gliomas.

Dr. Nicolas Reyns
Guest Editor

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Keywords

  • neurosurgery
  • neurological surgery
  • brain surgery
  • gliomas

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Published Papers (1 paper)

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30 pages, 1617 KiB  
Systematic Review
Fluorescence-Guided Surgical Techniques in Adult Diffuse Low-Grade Gliomas: State-of-the-Art and Emerging Techniques: A Systematic Review
by Thiebaud Picart, Arthur Gautheron, Charly Caredda, Cédric Ray, Laurent Mahieu-Williame, Bruno Montcel and Jacques Guyotat
Cancers 2024, 16(15), 2698; https://doi.org/10.3390/cancers16152698 - 29 Jul 2024
Viewed by 874
Abstract
Diffuse low-grade gliomas are infiltrative tumors whose margins are not distinguishable from the adjacent healthy brain parenchyma. The aim was to precisely examine the results provided by the intraoperative use of macroscopic fluorescence in diffuse low-grade gliomas and to describe the new fluorescence-based [...] Read more.
Diffuse low-grade gliomas are infiltrative tumors whose margins are not distinguishable from the adjacent healthy brain parenchyma. The aim was to precisely examine the results provided by the intraoperative use of macroscopic fluorescence in diffuse low-grade gliomas and to describe the new fluorescence-based techniques capable of guiding the resection of low-grade gliomas. Only about 20% and 50% of low-grade gliomas are macroscopically fluorescent after 5-amino-levulinic acid (5-ALA) or fluorescein sodium intake, respectively. However, 5-ALA is helpful for detecting anaplastic foci, and thus choosing the best biopsy targets in diffuse gliomas. Spectroscopic detection of 5-ALA-induced fluorescence can detect very low and non-macroscopically visible concentrations of protoporphyrin IX, a 5-ALA metabolite, and, consequently, has excellent performances for the detection of low-grade gliomas. Moreover, these tumors have a specific spectroscopic signature with two fluorescence emission peaks, which is useful for distinguishing them not only from healthy brain but also from high-grade gliomas. Confocal laser endomicroscopy can generate intraoperative optic biopsies, but its sensitivity remains limited. In the future, the coupled measurement of autofluorescence and induced fluorescence, and the introduction of fluorescence detection technologies providing a wider field of view could result in the development of operator-friendly tools implementable in the operative routine. Full article
(This article belongs to the Special Issue Neurosurgical Management of Gliomas)
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