The importance of surgical resection in malignant glioma

Purpose of review There is still controversy surrounding the role of cytoreductive surgery in the management of malignant gliomas because randomized studies have been missing. Here we review recent data from prospective studies that provide novel arguments in support of surgery. Recent findings Presently available studies not only demonstrate a benefit of surgical resection of malignant gliomas compared with biopsy. Data from a randomized surgical study on a technique for identifying residual tumour intraoperatively also substantiate the beneficial role of maximal cytoreduction in patients treated by resection. Potential mechanisms appear to be linked to the removal of the therapy-resistant, hypoxic, and highly-proliferative tumour core. Summary Clinical data currently available support the use of surgery for the management of malignant glioma. Surgery improves survival and may enhance the efficacy of adjunct and adjuvant therapies.