Dilemma in low-grade glioma surgery: Review of litreture and when to operate

Abstract

Diffuse low-grade gliomas (LGG) are tumours of the glial tissue, which are generally slow-growing, but have the potential to undergo anaplastic progression into more aggressive tumours. Diffuse low-grade gliomas (LGG) represent a heterogeneous group of primary brain tumour arising from supporting glial cells. The role of surgery in the management of human low- gliomas has been controversial. The current adjuvant therapies have facilitated treatment of patients, and have rendered neurosurgical removal without morbidity or mortality more commonplace than ever before. Here, we investigated the role of neurosurgery in the management of adults with low-grade gliomas. The management of low- grade glioma is one of the most controversial areas in clinical neuro-oncology. The concept of management of low-grade gliomas is not unitary but much more a composite of different challenges depending on the clinical presentation, signs, neuroradiology, perspectives of neurologists, the opinion of the neurosurgeon, and perhaps most importantly, the aspirations of the patient. It is true therefore that in many patients there will be a dilemma about what is considered optimal management since there is no good evidence base to underpin any single management. Even though there is substantial evidence which claims that surgery have a role to play in extending patient survival.