Motor outcome after resective surgery for the central lobe gliomas

Abstract

Background: Extent of resection (EOR) plays a major role in the prognosis on patients with gliomas, although the postoperative functionality of the patient is of great importance as well. It is why many surgeons advocate to not operate extensively on tumors that involve eloquent regions such as the central lobe. Recent series have demonstrated that it is possible to achieve extensive resections in this area without significantly affecting the functional outcome for these patients. We illustrate this issue with the experience obtained at the National Institute of Neurology and Neurosurgery in Mexico City. Methods: This is an observational and retrospective study that included patients that received surgical resection for intracranial gliomas that involved the central lobe at the National Institute of Neurology and Neurosurgery of Mexico, between January 2017 and May 2020. Demographic and clinical variables of the patients at the time of diagnosis were collected as well as tumor morphological variables, surgical adjuncts, and clinical outcomes. Statistical analysis was performed with SPSS software. Results: A total of 28 patients were included in the study with 43% of patients having a motor deficit before surgery. The average EOR was 88.6%. Patients presented with worsening of their motor status in the immediate postoperative period in 21% of the cases, although most of the patients recovered within the 1st month of follow-up. After analyzing all variables, not having a presurgical motor deficit was a statistically significant risk factor for developing a new motor deficit in the immediate postoperative period (P: 0.02). Conclusion: A resective surgery for gliomas near or within the central lobe can be performed safely and a satisfactory motor outcome for patients can be achieved without sacrificing the EOR. An intact presurgical motor status is a risk factor for developing a new deficit after surgery.

Precise Control of Glioma Cell Apoptosis Induced by Micro-Plasma-Activated Water (μ-PAW)

“…There are also scholars, such as Rühm et al, who used molecular stereotactic biopsy to accurately locate gliomas [19]. However, the current comprehensive treatment has certain side effects, such as incomplete removal by surgery, destruction of functional areas, and indiscriminate killing of normal nerve cells and glioma cells by radioactive elements during radiation therapy [20,21]. Chemotherapy, in contrast, is not only limited by the drug tolerance of glioma (e.g., platinum-based chemotherapeutic agents, a class of chemotherapeutic agents that affect the cell cycle, are not effective, because gliomas are resistant to platinum-based drugs [22]) but also decreases neurocognitive and other functions [23,24].…”