Advancements in Glioma Care: Focus on Emerging Neurosurgical Techniques

Abstract

Background: Despite significant advances in understanding the molecular pathways of glioma, translating this knowledge into effective long-term solutions remains a challenge. Indeed, gliomas pose a significant challenge to neurosurgical oncology because of their diverse histopathological features, genetic heterogeneity, and clinical manifestations. Relevant sections: This study focuses on glioma complexity by reviewing recent advances in their management, also considering new classification systems and emerging neurosurgical techniques. To bridge the gap between new neurosurgical approaches and standards of care, the importance of molecular diagnosis and the use of techniques such as laser interstitial thermal therapy (LITT) and focused ultrasound (FUS) are emphasized, exploring how the integration of molecular knowledge with emerging neurosurgical approaches can personalize and improve the treatment of gliomas. Conclusions: The choice between LITT and FUS should be tailored to each case, considering factors such as tumor characteristics and patient health. LITT is favored for larger, complex tumors, while FUS is standard for smaller, deep-seated ones. Both techniques are equally effective for small and superficial tumors. Our study provides clear guidance for treating pediatric low-grade gliomas and highlights the crucial roles of LITT and FUS in managing high-grade gliomas in adults. This research sets the stage for improved patient care and future developments in the field of neurosurgery.

The Transorbital Approach: A Comprehensive Review of Targets, Surgical Techniques, and Multiportal Variants

“…The transorbital approach has been investigated among the potentially minimally invasive approaches, along with endoscopic trans-maxillary, endoscopic endonasal, endoscopic transorbital, and endoscopic supracerebellar trans-tentorial, to highlight the potential of these endoscopic techniques compared to the traditional surgeries [28]. However, we recall that, in this context, there are functional neurosurgical techniques that simultaneously meet the goals of mini-invasiveness and safety and efficacy, such as laser interstitial thermal therapy (LITT) [29].…”

Clustering Functional Magnetic Resonance Imaging Time Series in Glioblastoma Characterization: A Review of the Evolution, Applications, and Potentials

“…To date, despite diagnostic and treatment efforts, GBM remains an incurable disease with a median survival of 15 months [ 10 ]. The rise in new functional neurosurgical techniques such as LITT and FUS in certain settings represents an example of the operative directions aimed at improving the prognoses of these patients [ 11 ]. GBM exhibits aggressive behavior largely due to its inherent intratumoral heterogeneity, which includes diverse cell populations and components of the microenvironment.…”

Treating Trigeminal Schwannoma through a Transorbital Approach: A Systematic Review

“…These tumors can often be effectively treated by complete surgical excision [7,8]. In addition to the patient's general indication for surgery, it is essential then to choose which approach to use and with what intent of radicality [9].…”