SURG-22SIGNIFICANCE OF MULTIMODAL ASSISTANT SYSTEMS FOR SURGERY OF GLIOBLASTOMA LOCATED IN ELOQUENT AREAS IN THE OUTCOME OF PATIENTS

Abstract

BACKGROUND: A goal of malignant glioma surgery is to maximally resect the tumor without neurological deficits. For doing so, multimodal assistant systems are essential, but their usefulness in the prognosis of the patients with glioblastomas (GB) at the eloquent areas (EA) is disputed. To clarify significance of multimodal assistant systems in glioma surgery, we investigated a resection rate, Karnofsky performance status (KPS), and survival in the patients with GB at the EA by comparing with those in the patients with GB at the non-EA. METHODS: Adult 74 patients with hemispheric GB who were received the tumor resection and followed by radio-chemotherapy (Stupp regimen) were enrolled in the study. Among these, 25 patients (34%) were GB in the EA (EA group) and 49 patients (66%) were GB in the non-EA (non-EA group). Multimodal assistant systems consisted of image-guided navigation, 5ALA-fluorescence visualization, and cortical/subcortical electrostimulation. Tumor resection rate, KPS, and survival (PFS,OS) in EA and non-EA groups were evaluated. RESULTS: Resection rates of EA group and non-EA group were 92.2% and 93%, respectively. In the EA group, KPS decreased a little 1 week after surgery, but returned to the preoperative level 1month after surgery. Both PFS and OS showed no significant difference between EA and non-EA groups (8.9M vs 10.4M, 14.3M vs 19.2M). In both EA and non-EA, resection rate greater than 95% showed significantly longer survival than partial resection. CONCLUSION: Multimodal assistant systems for glioma surgery was effective in the high resection rate of the tumor in the EA, resulting in longer survival of the patients with keeping their quality of life.