Glioblastoma multiforme surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Surgery is the mainstay of treatment for glioblastoma multiforme.

Surgery

1. Surgery is the mainstay of treatment for glioblastoma multiforme.

• The aim of surgery is to:
  • Make a definitive diagnosis
  • Debulk the tumor to relieve elevated intracranial pressure
  • Reduce the tumor mass as a precursor to adjuvant treatment

2. CSF shunting is performed to relieve the pressure in the brain due to blockade in the flow of cerebrospinal fluid by the tumor.

• External ventricular drain
  • Temporary shunt
• Internal drain
  • Permanent shunt
  • Drains CSF into the patient’s abdomen, where it is absorbed into the body

Surgery is the mainstay of treatment for glioblastoma multiforme.

• An average glioblastoma multiforme tumor contains 10¹¹ cells, which is reduced to 10⁹ cells after surgery (a reduction of 99%).
• Surgery is used to take a section for a pathological diagnosis, to remove the symptoms of a large mass pressing against the brain, to remove tumor before secondary resistance to radiotherapy and chemotherapy, and to prolong survival.
• Removal of 98% or more of the tumor has been associated with a better prognosis.
• The chances of near-complete initial removal of the tumor can be greatly increased if the surgery is guided by a fluorescent dye known as 5-aminolevulinic acid.
• Glioblastoma multiforme tumor cells are widely infiltrative through the brain at diagnosis. Despite a near-total resection, majority of people with glioblastoma multiforme develop recurrence, either at the original site or at distant satellite lesions within the brain.

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