Summary
This article presents the findings of 90 papers, published between 1990 and 2010, including more than 8000 adult patients who underwent resection of a supratentorial infiltrative glioma with and without intraoperative stimulation mapping (ISM). Intraoperative stimulation mapping is a surgical technique whereby the surgeon uses electric stimuli to localise certain areas of the brain for a more precise removal of tumour tissue. Compared to patients who had glioma resection without ISM, in those with ISM
- there were more occurrences of early severe (but temporary) deficits,
- less occurrences of late severe deficits,
- more frequently the tumour was removed completely (gross total resection),
- more often areas that directly control function (eloquent areas) of the brain were involved thus making ISM useful for more complex tumours.
The article is statistic-heavy, so the bottom line is: ISM should be used for glioma resection. Or as the authors conclude: “ISM is valuable in optimizing resective surgery by minimizing the rate of late severe deficits and maximizing the extent of (partial) resection, particularly for gliomas involving eloquent brain regions.”
If you’d like to hear from our BT-Online neurosurgeons on surgical techniques of brain tumours, outcomes and support, you can watch our “Neurosurgery Seminar”.
Full text
The full text is available here
Research publication
De Witt Hamer, P. C., Robles, S. G., Zwinderman, A. H., Duffau, H., & Berger, M. S. (2012). Impact of intraoperative stimulation brain mapping on glioma surgery outcome: a meta-analysis. J Clin Oncol, 30(20), 2559-2565. https://doi.org/10.1200/JCO.2011.38.4818