Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section
Introduction: The appropriate surgical management of insular gliomas is controversial. Management strategies vary considerably between centers. Research question: To provide robust resection, functional and epilepsy outcome figures, study growth patterns and tumor classification paradigms, analyze s...
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| Language: | English |
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Elsevier
2024-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529424000845 |
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| author | Matthias Simon Anne Hagemann Sanjana Gajadin Francesco Signorelli Arnaud J.P.E. Vincent |
| author_facet | Matthias Simon Anne Hagemann Sanjana Gajadin Francesco Signorelli Arnaud J.P.E. Vincent |
| author_sort | Matthias Simon |
| collection | DOAJ |
| description | Introduction: The appropriate surgical management of insular gliomas is controversial. Management strategies vary considerably between centers. Research question: To provide robust resection, functional and epilepsy outcome figures, study growth patterns and tumor classification paradigms, analyze surgical approaches, mapping/monitoring strategies, surgery for insular glioblastoma, as well as molecular findings, and to identify open questions for future research. Material and methods: On behalf of the EANS Neuro-oncology Section we performed a systematic review and meta-analysis (using a random-effects model) of the more current (2000–2023) literature in accordance with the PRISMA guidelines. Results: The pooled postoperative motor and speech deficit rates were 6.8% and 3.6%. There was a 79.6% chance for postoperative epilepsy control. The postoperative KPI was 80–100 in 83.5% of cases. Functional monitoring/mapping paradigms (which may include awake craniotomies) seem mandatory. (Additional) awake surgery may result in slightly better functional but also worse resection outcomes. Transcortical approaches may carry a lesser rate of (motor) deficits than transsylvian surgeries. Discussion and conclusions: This paper provides an inclusive overview and analysis of current surgical management of insular gliomas. Risks and complication rates in experienced centers do not necessarily compare unfavorably with the results of routine neuro-oncological procedures. Limitations of the current literature prominently include a lack of standardized outcome reporting. Questions and issues that warrant more attention include surgery for insular glioblastomas and how to classify the various growth patterns of insular gliomas. |
| format | Article |
| id | doaj-art-2feecc9efd9f46409e06c16cb6df200e |
| institution | OA Journals |
| issn | 2772-5294 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-2feecc9efd9f46409e06c16cb6df200e2025-08-20T01:56:24ZengElsevierBrain and Spine2772-52942024-01-01410282810.1016/j.bas.2024.102828Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology sectionMatthias Simon0Anne Hagemann1Sanjana Gajadin2Francesco Signorelli3Arnaud J.P.E. Vincent4Dept. of Neurosurgery, Bethel Clinic, University of Bielefeld Medical Center OWL, Bielefeld, Germany; Corresponding author. Department of Neurosurgery, Bethel Clinic University of Bielefeld Medical Center OWL, Kantensiek 11, 33617 Bielefeld. Germany.Society for Epilepsy Research, Bielefeld, GermanyDepartment of Neurosurgery, Erasmus Medical Center, Rotterdam, the NetherlandsDivision of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University ''Aldo Moro'', Bari, ItalyDivision of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University ''Aldo Moro'', Bari, ItalyIntroduction: The appropriate surgical management of insular gliomas is controversial. Management strategies vary considerably between centers. Research question: To provide robust resection, functional and epilepsy outcome figures, study growth patterns and tumor classification paradigms, analyze surgical approaches, mapping/monitoring strategies, surgery for insular glioblastoma, as well as molecular findings, and to identify open questions for future research. Material and methods: On behalf of the EANS Neuro-oncology Section we performed a systematic review and meta-analysis (using a random-effects model) of the more current (2000–2023) literature in accordance with the PRISMA guidelines. Results: The pooled postoperative motor and speech deficit rates were 6.8% and 3.6%. There was a 79.6% chance for postoperative epilepsy control. The postoperative KPI was 80–100 in 83.5% of cases. Functional monitoring/mapping paradigms (which may include awake craniotomies) seem mandatory. (Additional) awake surgery may result in slightly better functional but also worse resection outcomes. Transcortical approaches may carry a lesser rate of (motor) deficits than transsylvian surgeries. Discussion and conclusions: This paper provides an inclusive overview and analysis of current surgical management of insular gliomas. Risks and complication rates in experienced centers do not necessarily compare unfavorably with the results of routine neuro-oncological procedures. Limitations of the current literature prominently include a lack of standardized outcome reporting. Questions and issues that warrant more attention include surgery for insular glioblastomas and how to classify the various growth patterns of insular gliomas.http://www.sciencedirect.com/science/article/pii/S2772529424000845Insular gliomaExtent of resectionEpilepsyMonitoring/mappingAwake craniotomy |
| spellingShingle | Matthias Simon Anne Hagemann Sanjana Gajadin Francesco Signorelli Arnaud J.P.E. Vincent Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section Brain and Spine Insular glioma Extent of resection Epilepsy Monitoring/mapping Awake craniotomy |
| title | Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section |
| title_full | Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section |
| title_fullStr | Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section |
| title_full_unstemmed | Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section |
| title_short | Surgical treatment for insular gliomas. A systematic review and meta-analysis on behalf of the EANS neuro-oncology section |
| title_sort | surgical treatment for insular gliomas a systematic review and meta analysis on behalf of the eans neuro oncology section |
| topic | Insular glioma Extent of resection Epilepsy Monitoring/mapping Awake craniotomy |
| url | http://www.sciencedirect.com/science/article/pii/S2772529424000845 |
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