Perioperative Management of Patients with Glioblastoma

In GBM, statistically significant prognostic advantage begins at a level of volumetric resection of 70% to 78% and steadily increases as it approaches 100%. Because of its infiltrative nature, it is not always possible to achieve gross total resection while preserving neurologic function. Obtaining maximal resection with the least amount of morbidity is the goal of surgery. Several strategies can be used to achieve this goal, including IMRI, DTI, 5-ALA, and performing the surgery with the patient awake and continuous mapping. Given the complexity of the care needed for the perioperative management of patients with GBM, a multidisciplinary team is needed.

Automated summary

In glioblastoma surgery, a statistically significant prognostic advantage starts at a volumetric resection level of 70% to 78% and increases steadily towards 100%, but complete resection is not always achievable due to the tumor's infiltrative nature. The goal of surgery is to achieve maximal resection with minimal morbidity, which can be done through various strategies such as intraoperative MRI, DTI, 5-ALA, and awake continuous mapping. A multidisciplinary team is necessary for the complex perioperative care needed for glioblastoma patients.