Supratotal resection [Neurosurgery Wiki]

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====== Supratotal resection ======

The literature suggests insufficient evidence for carte blanche application of [[supratotal]] resection, particularly in lower-grade gliomas where neurological deficits can result in long-term disability. While the preliminary studies discussed here, containing data from only a few centers, have reported increased progression-free and overall survival, these claims require validation in prospective research studies involving larger patient populations with clearly defined appropriate outcome metrics in order to reduce potential bias
((de Leeuw CN, Vogelbaum MA. Supratotal resection in glioma: a systematic review. Neuro Oncol. 2019 Feb 14;21(2):179-188. doi: 10.1093/neuonc/noy166. PMID: 30321384; PMCID: PMC6374756.)).
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The postoperative [[seizure]] freedom represents an important secondary outcome measure in [[glioblastoma]] surgery. Supra-total glioblastoma resection in terms of [[anterior temporal lobectomy]] (ATL) has gained growing attention with regard to superior long-term disease control for temporal-located glioblastoma compared to conventional [[gross total resection]]s (GTR). However, the impact of ATL on seizure outcome in these patients is unknown.

In a study of  Borger et al. from the [[University Hospital Bonn.]] in terms of a [[supratotal resection]] strategy was associated with superior favorable seizure outcome following temporal glioblastoma resection compared to GTR. Regarding the above-mentioned survival benefit following ATL compared to GTR, ATL as an aggressive supra-total resection regime might constitute the surgical modality of choice for temporal-located glioblastoma
((Borger V, Hamed M, Ilic I, Potthoff AL, Racz A, Schäfer N, Güresir E, Surges R, Herrlinger U, Vatter H, Schneider M, Schuss P. Seizure outcome in temporal glioblastoma surgery: lobectomy as a supratotal resection regime outclasses conventional gross-total resection. J Neurooncol. 2021 Feb 7. doi: 10.1007/s11060-021-03705-x. Epub ahead of print. PMID: 33554293.)).