Evidence-based advances in glioma management

Abstract

Glioma is primary brain tumors of the glial origin. Glioblastoma multiforme traditionally classified as Grade IV glial tumor carries the worst prognosis. Over the past decades, focus of the diagnosis and management has gradually shifted toward molecular and genetic profiling. This has been accompanied by advancement in radiology, radiation, and medical oncology. Despite significant progress in the individual disciplines, the overall prognosis has not increased significantly. There is consensus on the need of maximum safe resection for most of these tumors. Details of anatomy and white matter tracts obtained through preoperative imaging. These detailed radiological modalities allow the surgeons to plan a safe trajectory to the lesion, avoiding neurological complications. Five aminolevulinic acid and fluorescein guidance help increasing the extent of resection. Awake craniotomy with brain mapping has regained popularity for the safe resection of low-grade glioma, especially those located in eloquent areas. In this review article, we have discussed various aspect of glioma management including diagnosis and surgical resection.