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Review
. 2021 Mar 2:11:645854.
doi: 10.3389/fonc.2021.645854. eCollection 2021.

Brain Mapping-Aided SupraTotal Resection (SpTR) of Brain Tumors: The Role of Brain Connectivity

Giuseppe Roberto Giammalva  1 , Lara Brunasso  1 , Roberta Costanzo  1 , Federica Paolini  1 , Giuseppe Emmanuele Umana  2 , Gianluca Scalia  3 , Cesare Gagliardo  4 , Rosa Maria Gerardi  1 , Luigi Basile  1 , Francesca Graziano  3 , Carlo Gulì  1 , Domenico Messina  1 , Maria Angela Pino  1 , Paola Feraco  5 , Silvana Tumbiolo  6 , Massimo Midiri  1 , Domenico Gerardo Iacopino  1 , Rosario Maugeri  1
Affiliations
Review

Brain Mapping-Aided SupraTotal Resection (SpTR) of Brain Tumors: The Role of Brain Connectivity

Giuseppe Roberto Giammalva et al. Front Oncol. .

Abstract

Brain gliomas require a deep knowledge of their effects on brain connectivity. Understanding the complex relationship between tumor and functional brain is the preliminary and fundamental step for the subsequent surgery. The extent of resection (EOR) is an independent variable of surgical effectiveness and it correlates with the overall survival. Until now, great efforts have been made to achieve gross total resection (GTR) as the standard of care of brain tumor patients. However, high and low-grade gliomas have an infiltrative behavior and peritumoral white matter is often infiltrated by tumoral cells. According to these evidences, many efforts have been made to push the boundary of the resection beyond the contrast-enhanced lesion core on T1w MRI, in the so called supratotal resection (SpTR). SpTR is aimed to maximize the extent of resection and thus the overall survival. SpTR of primary brain tumors is a feasible technique and its safety is improved by intraoperative neuromonitoring and advanced neuroimaging. Only transient cognitive impairments have been reported in SpTR patients compared to GTR patients. Moreover, SpTR is related to a longer overall and progression-free survival along with preserving neuro-cognitive functions and quality of life.

Keywords: brain connectome; brain mapping; brain tumor; connectomics; extent of resection; high-grade gliomas; low-grade gliomas; supratotal resection.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow-diagram of the results of this systematic review according to PRISMA statement.
See this image and copyright information in PMC

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