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Cancers
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Multidisciplinary Advances and Surgical Impact in Brain and Central Nervous...
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Multidisciplinary Advances and Surgical Impact in Brain and Central Nervous System Tumors: From Molecular Insights to Clinical Outcomes

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: 10 October 2026 | Viewed by 1099

Special Issue Editors

Dr. Paolo Tini

E-Mail Website
Guest Editor
Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, 53100 Siena, Italy
Interests: neuro-oncology; radiotherapy in CNS cancers; radiosurgery; bio-molecular prognostic factors
Special Issues, Collections and Topics in MDPI journals
Dr. Salvatore Chibbaro

E-Mail Website
Guest Editor
Neurosurgery, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
Interests: neurosurgery; brain tumors; glioma; neuro-oncology
Dr. Mario Ganau

E-Mail Website
Guest Editor
1. Department of Neurosurgery, Oxford University Hospitals NHS Foundation, Oxford OX3 9DU, UK
2. School of Medicine, BAU International University Batumi, 237 Fridon Khalvashi ST, Batumi, Georgia
Interests: adenomas, gliomas, meningiomas; traumatic brain injury; spinal cord injury; cranio-cervical junction; transphenoidal endoscopy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Brain and central nervous system (CNS) tumors remain among the most complex and heterogeneous malignancies, requiring a highly integrated multidisciplinary approach to optimize diagnosis, treatment, and long-term outcomes. In recent years, the convergence of precision neurosurgery, advanced neuroimaging, intraoperative mapping, and molecular profiling has reshaped the way clinicians understand and manage these diseases.

This Special Issue aims to explore the evolving role of surgery within the multidisciplinary management of CNS tumors—from gliomas and meningiomas to metastatic and pediatric entities—and its interplay with radiotherapy, systemic therapies, and molecularly guided precision medicine. Emphasis will be placed on the integration of neurosurgical, neuro-oncological, radiotherapeutic, and neuropathological expertise to improve patient outcomes.

Contributions are invited on translational research, innovative surgical and imaging techniques, intraoperative monitoring, liquid biopsy, and molecular predictors of surgical outcomes, as well as studies highlighting the synergy between surgery and adjuvant or neoadjuvant treatments. Topics may also include the use of artificial intelligence, radiomics, and digital pathology to support decision-making in a multidisciplinary setting and to personalize therapeutic strategies.

Both clinical and translational studies, systematic reviews, and illustrative case series that provide novel insights into the optimization of surgical management and its impact on patient outcomes are welcome.

We believe this scope will allow for a comprehensive and contemporary view of CNS tumor management, fully aligned with Cancers’ multidisciplinary mission.

Dr. Paolo Tini
Dr. Salvatore Chibbaro
Dr. Mario Ganau
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • glioblastoma
  • low-grade gliomas
  • ependymomas
  • PNET
  • meningiomas
  • medulloblastomas
  • other brain tumors

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Published Papers (1 paper)

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Review

18 pages, 3419 KB  
Review
Beyond Resection: Surgery as an Evolutionary Bottleneck Shaping Tumor Evolution and Treatment Response in Diffuse Gliomas
by Paolo Tini, Flavio Donnini, Giovanni Rubino, Giuseppe Battaglia, Pierpaolo Pastina, Marta Vannini, Tommaso Carfagno, Giacomo Tiezzi, Ludovica Cellini, Giuseppe Minniti and Salvatore Chibbaro
Cancers 2026, 18(6), 1012; https://doi.org/10.3390/cancers18061012 - 20 Mar 2026
Viewed by 754
Abstract
Surgical resection remains a cornerstone in the multidisciplinary management of central nervous system (CNS) tumors, particularly diffuse gliomas. Traditionally, the role of surgery has been evaluated primarily through quantitative metrics such as extent of resection and its association with survival outcomes. However, despite [...] Read more.
Surgical resection remains a cornerstone in the multidisciplinary management of central nervous system (CNS) tumors, particularly diffuse gliomas. Traditionally, the role of surgery has been evaluated primarily through quantitative metrics such as extent of resection and its association with survival outcomes. However, despite maximal and radiologically complete resections, recurrence remains nearly universal in malignant CNS tumors, suggesting that surgical cytoreduction alone does not fully account for post-surgical disease dynamics. Emerging biological and molecular evidence indicates that surgery represents not merely a technical intervention, but a biologically active event that profoundly reshapes tumor evolution and treatment response. In this review, we propose a conceptual framework that redefines surgery as a key biological driver in CNS tumor progression. We synthesize evidence demonstrating that surgical trauma induces inflammation, hypoxia, vascular remodeling, immune modulation, and extracellular matrix reorganization, collectively reprogramming the residual tumor microenvironment. These changes create selective pressures that favor the survival and expansion of adaptive tumor cell subpopulations, including invasive and stem-like phenotypes. From an evolutionary perspective, surgical resection functions as an acute selective bottleneck acting on heterogeneous tumor ecosystems, contributing to clonal selection and molecular divergence at recurrence. We further examine the dissociation between surgical (anatomical) margins and molecular (biological) margins, highlighting how biologically active tumor cells infiltrate beyond radiologically defined boundaries. This discrepancy provides a biological explanation for marginal and distant recurrences and challenges anatomy-based paradigms of surgical completeness. Importantly, we discuss how surgery-induced biological changes influence postoperative radiotherapy and systemic therapies, affecting radiosensitivity, target delineation, and therapeutic vulnerability. Finally, we outline future directions toward surgery-integrated precision neuro-oncology, emphasizing the potential of spatial profiling, liquid biopsy, advanced imaging, and artificial intelligence to capture perioperative tumor evolution. By reframing surgery as a biological inflection point rather than a neutral prelude to adjuvant treatment, this review advocates for a dynamic, biology-driven continuum of care aimed at anticipating tumor adaptation and improving long-term disease control in CNS tumors. Full article
(This article belongs to the Special Issue Multidisciplinary Advances and Surgical Impact in Brain and Central Nervous System Tumors: From Molecular Insights to Clinical Outcomes)
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