Surgical Advances in the Treatment of Gliomas: Preserving Function and Quality of Life

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

Deadline for manuscript submissions: 7 March 2025 | Viewed by 1249

Special Issue Editors


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Guest Editor
King's College Hospital NHS Foundation Trust, London, UK
Interests: neuroanatomy; neuro-oncology; awake craniotomy; intraoperative neuro-monitoring; brain mapping; tractography; transcranial magnetic stimulation

E-Mail Website
Guest Editor
King's College Hospital NHS Foundation Trust, London, UK
Interests: neuro-oncology; intraoperative neuromonitoring; navigated transcranial magnetic stimulation; fMRI; tractography; neuro-anatomy
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Special Issue Information

Dear Colleagues,

While the neuro-oncology community has witnessed significant developments in recent years, surgery remains at the forefront of glioma treatment. Its role has been established in increasing progression-free and overall survival, both in low- and high-grade gliomas. At the same time, obtaining as much tissue as possible has become essential in an era of improved diagnosis through next-generation sequencing and individualized treatment with targeted chemotherapy and immunotherapy.

Maximal tumor debulking, however, cannot be achieved at the expense of neurological function or quality of life, a concept usually described as “onco-functional balance,” which has emerged as a new surgical paradigm.

In this Special Issue, we focus on different aspects related to improving the surgical care of patients. We intentionally consider the term “surgical advances” in a broader sense, aiming at a multidisciplinary audience and inviting contributions from neurosurgeons, imaging scientists, neurophysiologists, neuropsychologists, linguistics, and all the different practitioners involved in the surgical treatment of neuro-oncology patients.

In this spirit, we welcome contributions related to pre-surgical planning (e.g., concerning new techniques or novel applications of brain imaging and/or non-invasive brain mapping), intraoperative management of gliomas (e.g., neurophysiology monitoring, techniques of awake craniotomy and mapping, and intraoperative image guidance), and post-operative assessment (e.g., new techniques of rehabilitation and mechanisms of brain plasticity).

This integrated and multidisciplinary approach, we are sure, is crucial to surgical development and key to preserving function and quality of life in our patients.

Dr. Francesco Vergani
Dr. José Pedro Lavrador
Guest Editors

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Keywords

  • neuro-oncology
  • brain mapping
  • neuroimaging
  • intraoperative neuro-monitoring
  • functional MRI
  • transcranial magnetic stimulation
  • neurorehabilitation

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Published Papers (1 paper)

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Research

16 pages, 5515 KiB  
Article
Asymmetry of the Frontal Aslant Tract and Development of Supplementary Motor Area Syndrome
by Jahard M. Aliaga-Arias, Josephine Jung, Jose Pedro Lavrador, Kapil Rajwani, Ana Mirallave-Pescador, Amy Jones, Hilary Wren, Richard Gullan, Ranj Bhangoo, Keyoumars Ashkan, Flavio Dell’Acqua and Francesco Vergani
Cancers 2024, 16(22), 3739; https://doi.org/10.3390/cancers16223739 - 5 Nov 2024
Viewed by 829
Abstract
Background/Objectives: The purpose of this study was to investigate preoperative interhemispheric differences of the FAT in relation to the onset of postoperative SMA syndrome. Methods: This was a single-center retrospective analysis of patients who underwent surgical resection of diffuse gliomas involving the SMA [...] Read more.
Background/Objectives: The purpose of this study was to investigate preoperative interhemispheric differences of the FAT in relation to the onset of postoperative SMA syndrome. Methods: This was a single-center retrospective analysis of patients who underwent surgical resection of diffuse gliomas involving the SMA between 2018 and 2022. Inclusion criteria were availability of preoperative and postoperative Magnetic Resonance Imaging, no previous surgery, and no neurological deficits at presentation. Diffusion-weighted data were processed by spherical deconvolution (SD) and diffusion tensor imaging tractography algorithms, and TrackVis was used to dissect the FAT of both hemispheres. The FAT data were analyzed for correlation with postoperative SMA syndrome onset. Results: N = 25 cases were included in the study, among which n = 23 had preoperative bilaterally identifiable FAT by SD. N = 12 developed an SMA syndrome, 6 demonstrated a motor-only syndrome, 4 had a verbal-only syndrome, and 2 had mixed verbal and motor features. The SMA syndrome incidence was significantly more frequent in lower-grade gliomas (p = 0.005). On the tumor side, the FAT identified by SD was smaller than the contralateral (mean volume 6.53 cm3 and 13.33 cm3, respectively, p < 0.001). In the 6 cases that developed a verbal SMA syndrome, a normalized FAT volume asymmetry (FAT-VA) demonstrated an asymmetry shifted towards the non-dominant side (mean FAT-VA = −0.68), while the cases with no postoperative verbal impairment had opposite asymmetry towards the dominant side (mean FAT-VA = 0.42, p = 0.010). Conclusions: Preoperative interhemispheric FAT volume asymmetry estimated according to functional dominance can predict postoperative onset of verbal SMA syndrome, with proportionally smaller FAT on the affected dominant hemisphere. Full article
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