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 1).
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 resections (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 2).