Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
The 71st Annual Meeting Special Topics — Part III: Treatment Strategy of Low Grade Glioma
Summary of 15 Years Experience of Awake Surgeries for Neuroepithelial Tumors in Tohoku University
Toshihiro KUMABE, Kiyotaka SATO, Masaki IWASAKI, Ichiyo SHIBAHARA, Tomohiro KAWAGUCHI, Ryuta SAITO, Masayuki KANAMORI, Yoji YAMASHITA, Yukihiko SONODA, Osamu IIZUKA, Kyoko SUZUKI, Ken-ichi NAGAMATSU, Shintaro SEKI, Nobukazu NAKASATO, Teiji TOMINAGA
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Keywords: awake surgery, electrical stimulation, glioma, language mapping, outcome
JOURNAL OPEN ACCESS

2013 Volume 53 Issue 7 Pages 455-466

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Abstract

We retrospectively analyzed 15 years experience of awake surgeries for neuroepithelial tumors in Tohoku University. Awake surgeries mostly for language mapping were performed for 42 of 681 newly diagnosed cases (6.2%) and 59 of 985 surgeries including for recurrence (6.0%). When the same histologies and locations as cases resected under awake condition are selected from the parent population treated by radical resection, awake surgeries were most frequently performed for 14 of 55 newly diagnosed cases (25.5%) and 14 of 62 surgeries (22.6%) with grade II gliomas. In the results, 8 of 59 surgeries (13.6%) could not achieve complete language monitoring until the final stage of tumor resection, considered as failed awake surgery. Gross total resection was accomplished in 20 of 42 newly diagnosed cases (47.6%) and 32 of 59 surgeries (54.2%). Mortality rate was 0%. Late severe deficits were observed in 2 of 42 newly diagnosed cases (4.8%) and 3 of 59 surgeries (5.1%). Negative language mapping cases did not suffer severe deficits in both early and late stages. In contrast, high incidence of severe deficits, 3 as early and 2 as late of 8 cases, were identified with failed awake surgery. The overall survival of patients treated by awake surgery compared favorably with those treated without stimulation mapping and with stimulation mapping under general anesthesia. Awake surgery may contribute to improve the outcome of gliomas near eloquent areas by maximizing the tumor resection and minimizing the surgical morbidity.

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© 2013 by The Japan Neurosurgical Society

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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