Surgical resection of glioma involving eloquent brain areas: Tumor boundary, functional boundary, and plasticity consideration

Abstract

Glioma is the most refractory intracranial tumor, and its diffuse infiltrative growth characteristics make total resection impossible in a biological sense, especially when tumors invade eloquent brain areas. Thus, identifying the equilibrium between tumor resection and functional preservation remains a challenge in glioma surgery. The accurate identification of tumor boundaries, precise mapping of functional boundaries, and an in-depth understanding of functional plasticity are key factors for accomplishing this challenge. This article reviews these three key points and highlights potential perspectives for the development of glioma surgery.