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

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 effectiven...

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Published inFrontiers in oncology Vol. 11; p. 645854
Main Authors Giammalva, Giuseppe Roberto, Brunasso, Lara, Costanzo, Roberta, Paolini, Federica, Umana, Giuseppe Emmanuele, Scalia, Gianluca, Gagliardo, Cesare, Gerardi, Rosa Maria, Basile, Luigi, Graziano, Francesca, Gulì, Carlo, Messina, Domenico, Pino, Maria Angela, Feraco, Paola, Tumbiolo, Silvana, Midiri, Massimo, Iacopino, Domenico Gerardo, Maugeri, Rosario
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 02.03.2021
Subjects
brain connectome
brain mapping
connectomics
high-grade gliomas
low-grade gliomas
Oncology
supratotal resection
brain mapping
connectomics
brain connectome
extent of resection
supratotal resection
brain tumor
high-grade gliomas
low-grade gliomas
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Summary: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.
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Edited by: Giovanni Raffa, University of Messina, Italy
This article was submitted to Neuro-Oncology and Neurosurgical Oncology, a section of the journal Frontiers in Oncology
Reviewed by: Matteo Zoli, IRCCS Institute of Neurological Sciences of Bologna (ISNB), Italy; Gianluca Trevisi, Azienda USL di Pescara, Italy
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2021.645854