gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Clinical results and pitfall of insula glioma surgery

Meeting Abstract

  • T. Maruyama - Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan; Faculty of Advanced Techno-Surgery(FATS), Institute of Advanced Biomedical Engineering & Science, Graduate School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
  • Y. Muragaki - Faculty of Advanced Techno-Surgery(FATS), Institute of Advanced Biomedical Engineering & Science, Graduate School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
  • M. Nitta - Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
  • H. Iseki - Faculty of Advanced Techno-Surgery(FATS), Institute of Advanced Biomedical Engineering & Science, Graduate School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
  • Y. Okada - Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.10.02

DOI: 10.3205/12dgnc092, URN: urn:nbn:de:0183-12dgnc0925

Published: June 4, 2012

© 2012 Maruyama et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Insula glioma is one of the surgical challenging tumors due to surrounding anatomy include neuronal fiber and vasculature. We have been trying aggressive tumor removal using intraoperative MRI and functional monitoring technique. This tumors are entrenched in eloquent tissue and surrounded by microvasculature serving critical language and motor systems.

Methods: We analyzed patients morbidity, extent of resection and its impact on progression free survival retrospectively. Important surgical procedure were 1) preservation of surrounding functional area using monitoring and awake craniotomy and 2) careful identification and dissection of LSA.

Results: 95 patients involving 45 of pure insula glioma were applied. Patients presented with grade 2 in 31 cases, grade 3 in 11 cases and small insula localized grade 4 in 2 cases. 16 / 24 dominant hemisphere cases were removed under awake craniotomy. Tumor removal rate was 90% in tumor localized within insula and 86% in tumor extend to other lobes such as frontal and/or temporal. Tumor recurrence were 8 / 31 in grade 2 and 3 / 11 in grade 3. Mean removal rate of recurrent tumor was 82.1%. Mean time of tumor progression was 32 months in grade 2 and 20 months in grade 3.

Conclusions: Aggressive tumor resection of insula glioma can be accomplished with acceptable morbidity and is predictive of improved TTF. We introduce our surgical technique and result.