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Brain Sci. 2017, 7(12), 166; https://doi.org/10.3390/brainsci7120166

Advances in Brain Tumor Surgery for Glioblastoma in Adults

1
Department of Neurosurgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA
2
Department of Medicine, National Autonomous University of Mexico (UNAM), Av. Universidad, Coyoacan, Mexico City 04510, Mexico
3
Mayo Clinic College of Medicine, Mayo Clinic Graduate School, Rochester, MN 55905, USA
4
Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX 78712, USA
5
Department of Neurosurgery, University of Florida College of Medicine, 653 8th St W., Jacksonville, FL 32209, USA
*
Authors to whom correspondence should be addressed.
Received: 17 October 2017 / Revised: 24 November 2017 / Accepted: 13 December 2017 / Published: 20 December 2017
(This article belongs to the Special Issue Advances in Adult and Pediatric Brain Tumor Management)
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Abstract

Glioblastoma (GBM) is the most common primary intracranial neoplasia, and is characterized by its extremely poor prognosis. Despite maximum surgery, chemotherapy, and radiation, the histological heterogeneity of GBM makes total eradication impossible, due to residual cancer cells invading the parenchyma, which is not otherwise seen in radiographic images. Even with gross total resection, the heterogeneity and the dormant nature of brain tumor initiating cells allow for therapeutic evasion, contributing to its recurrence and malignant progression, and severely impacting survival. Visual delimitation of the tumor’s margins with common surgical techniques is a challenge faced by many surgeons. In an attempt to achieve optimal safe resection, advances in approaches allowing intraoperative analysis of cancer and non-cancer tissue have been developed and applied in humans resulting in improved outcomes. In addition, functional paradigms based on stimulation techniques to map the brain’s electrical activity have optimized glioma resection in eloquent areas such as the Broca’s, Wernike’s and perirolandic areas. In this review, we will elaborate on the current standard therapy for newly diagnosed and recurrent glioblastoma with a focus on surgical approaches. We will describe current technologies used for glioma resection, such as awake craniotomy, fluorescence guided surgery, laser interstitial thermal therapy and intraoperative mass spectrometry. Additionally, we will describe a newly developed tool that has shown promising results in preclinical experiments for brain cancer: optical coherence tomography. View Full-Text
Keywords: brain tumor surgery; laser therapy; awake craniotomy; novel treatments for glioma; optical coherence tomography brain tumor surgery; laser therapy; awake craniotomy; novel treatments for glioma; optical coherence tomography
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Lara-Velazquez, M.; Al-Kharboosh, R.; Jeanneret, S.; Vazquez-Ramos, C.; Mahato, D.; Tavanaiepour, D.; Rahmathulla, G.; Quinones-Hinojosa, A. Advances in Brain Tumor Surgery for Glioblastoma in Adults. Brain Sci. 2017, 7, 166.

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