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Accurate and sensitive pre-surgical identification of CMs allows for more targeted placement of intracranial EEG electrodes, potentially more complete resection of CMs, and improved surgical outcome.
The longer survival time after more complete resection as well as the frequent recurrence in the area of the primary site suggest that the recurrent gliomas arise from remaining primary tumor cells in or close to the wall of the resection cavity.
Intra-operative MRI during trans-sphenoidal microsurgery is useful in selected patients for a safe and more complete resection.
The assumption that an iMRI leads to a more complete resection can thus be a self-fulfilling prophecy.
Minimally invasive neurosurgical techniques, exemplified by endoscopic resection techniques 182 are being applied to resection of malignant gliomas, facilitating more complete resection of deeply located tumors, and intraventricular or periventricular tumors.
This observation has led to the investigation of Eph mAbs as potential imaging agents, which might accurately delineate tumour borders and better define areas of active invasion allowing more complete resection and better patient outcomes (Cai et al, 2007).
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This approach facilitated more complete tumor resection and even resection of (pre- malignant tissues that otherwise were not detected with the standard white-light endoscopre- malignant
However, the number of primary surgeries leaving residual tumor of more than 1 cm in diameter, is up to 40%, while during interval debulking surgery more often complete resection is achieved, without affecting survival [ 19, 20] Selecting patients who benefit from primary debulking surgery, i.e. in whom complete surgery results are possible, should be optimized.
Most changes at histologic revision were referred lipomas that were revised to well-differentiated liposarcoma, for which a more complete local resection is mandatory and follow-up should be prolonged.
This suggests that the atypical clinical behavior of PDAC in these patients may be due to unique tumor biology, rather than clinical features such as earlier stage or more complete surgical resection.
It is possible, in the present series, that the presence of white matter pathology allowed better discrimination of the extent of the lesion on MRI and a more complete cortical resection, compared to cases without this feature.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com