Surgery of insular and paralimbic diffuse low-grade gliomas: technical considerations.


:Once considered a "no man's land" especially when invaded by a diffuse low grade glioma (DLGG), the insula remains to this day a surgical challenge. Surgery for insular DLGG involves consideration of its hidden location under the potentially eloquent operculae, the proximity to vascular tree and high density of functions not only in the insular cortex but also in the white fiber pathways passing under the insular lobe. The natural history of DLGG and the potential benefits and consequences of the surgical approach also need a close look. In the last decade, a better knowledge of the functional anatomy and connectivity of this region, as well as an improvement in surgical techniques as direct stimulation mapping, combined with an increasing literature showing a favorable impact of maximal resection for DLGG, were deciding factors in the paradigmatic shift from expectative treatment to early surgical management. Here, our goal is to discuss the structural and functional aspects of the insula, the specificities of insular and paralimbic DLGG by emphasizing the technical considerations of surgery in this region, as well as its oncological and functional outcomes. In summary, this new strategy based upon early maximal safe surgical resection showed both oncological benefit and preservation of quality of life-or even an improvement thanks to epilepsy relief.


J Neurooncol


Michaud K,Duffau H




Has Abstract


2016-11-01 00:00:00














  • Phenotypic and functional characterization of Glioblastoma cancer stem cells identified through 5-aminolevulinic acid-assisted surgery [corrected].

    abstract::5-aminolevulinic acid (5-ALA) introduction in the surgical management of Glioblastoma (GBM) enables the intra-operatively identification of cancer cells in the mass by means of fluorescence. Here, we analyzed the phenotype of GBM cells isolated from distinct tumour areas determined by 5-ALA (tumour core, 5-ALA intense...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Rampazzo E,Della Puppa A,Frasson C,Battilana G,Bianco S,Scienza R,Basso G,Persano L

    更新日期:2014-02-01 00:00:00

  • A phase II trial of PTK787/ZK 222584 in recurrent or progressive radiation and surgery refractory meningiomas.

    abstract::When surgery and radiation are no longer treatment options, salvage systemic therapy has been used for recurrent meningiomas with little compelling evidence to suggest effectiveness. Patients with surgery and radiation refractory recurrent meningiomas were treated with the oral multifunctional tyrosine kinase inhibito...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Raizer JJ,Grimm SA,Rademaker A,Chandler JP,Muro K,Helenowski I,Rice L,McCarthy K,Johnston SK,Mrugala MM,Chamberlain M

    更新日期:2014-03-01 00:00:00

  • An analysis of radiation necrosis of the central nervous system treated with bevacizumab.

    abstract::Radiation necrosis is a devastating complication following radiation to the central nervous system. The purpose of this study was to perform a comprehensive analysis of cases in the literature using bevacizumab, a monoclonal antibody against vascular endothelial growth factor, as treatment for radiation necrosis. A ME...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Tye K,Engelhard HH,Slavin KV,Nicholas MK,Chmura SJ,Kwok Y,Ho DS,Weichselbaum RR,Koshy M

    更新日期:2014-04-01 00:00:00

  • Knockdown of GluR1 expression by RNA interference inhibits glioma proliferation.

    abstract::High-grade gliomas release excitotoxic concentrations of glutamate which contributes to their malignant phenotype. To improve our understanding of the mechanisms by which glutamate enhances tumor growth and invasion, we examined alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA)-mediated signaling in glio...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: de Groot JF,Piao Y,Lu L,Fuller GN,Yung WK

    更新日期:2008-06-01 00:00:00

  • Bevacizumab for radiation necrosis following treatment of high grade glioma: a systematic review of the literature.

    abstract::This review identifies the current literature on the use of bevacizumab for cerebral radiation necrosis in patients with high-grade gliomas, summarizes the clinical course and complications following bevacizumab, and discusses the relative costs and benefits of this therapeutic option. A Medline search was conducted o...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章,评审


    authors: Lubelski D,Abdullah KG,Weil RJ,Marko NF

    更新日期:2013-12-01 00:00:00

  • Ependymoma in children under the age of 3 years: a report from the Canadian Pediatric Brain Tumour Consortium.

    abstract::The determination of optimal therapy for ependymoma (EP) in infants is ongoing. We describe the incidence, management and outcomes of Canadian infants with EP to discern potential future research questions. Of 579 cases registered in a national database of children <36 months of age diagnosed with a brain tumor from 1...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Purdy E,Johnston DL,Bartels U,Fryer C,Carret AS,Crooks B,Eisenstat DD,Lafay-Cousin L,Larouche V,Wilson B,Zelcer S,Silva M,Bouffet E,Keene D,Strother DR

    更新日期:2014-04-01 00:00:00

  • Combination treatment of TRAIL, DFMO and radiation for malignant glioma cells.

    abstract::Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) has shown potent and cancer-selective killing activity and drawn considerable attention as a promising therapy for cancer. Another promising cancer therapy is difluoromethylornithine (DFMO), an inhibitor of ornithine decarboxylase, which is oraly administ...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Alexiou GA,Tsamis KI,Vartholomatos E,Peponi E,Tzima E,Tasiou I,Lykoudis E,Tsekeris P,Kyritsis AP

    更新日期:2015-06-01 00:00:00

  • Surgical resection for patients with benign primary brain tumors and low grade gliomas.

    abstract::'Benign' brain tumors are a heterogeneous group of primary neoplasms representing 40% of primary brain tumors. Amongst neuroepithelial tumors, astrocytic neoplasms predominate, followed by oligodendroglial and mixed glial and glial-neuronal neoplasms. Less common are tumors of the ependyma, choroid plexus and neuroepi...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章,评审


    authors: Piepmeier J,Baehring JM

    更新日期:2004-08-01 00:00:00

  • Multiple meningiomas: does quantity matter? a population-based survival analysis with underlined age and sex differences.

    abstract:INTRODUCTION:Intracranial meningiomas rarely present with multiple lesions. To the best of our knowledge, current literature regarding meningiomatosis (MM) is mostly comprised of small case series and individual reports. Hence, survival outcome data are limited. The Objective of this study is to explore the influence o...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Ramos-Fresnedo A,Domingo RA,Vivas-Buitrago T,Lundy L,Trifiletti DM,Jentoft ME,Desai AB,Quiñones-Hinojosa A

    更新日期:2020-09-01 00:00:00

  • Recovery of empathetic function following resection of insular gliomas.

    abstract::The insular cortex is located deep within the Sylvian fissure between multi-functional and structurally-compressed cerebral structures, and has been suggested to play an important role in both basic sensorimotor and complex social-emotional functions. Such structural and functional complexity presents a challenge for ...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Wang X,Gu X,Fan J,Wang S,Zhao F,Hof PR,Liu P,Gao Z

    更新日期:2014-04-01 00:00:00

  • Type 2 diabetes mellitus and obesity are independent risk factors for poor outcome in patients with high-grade glioma.

    abstract::Type 2 diabetes mellitus (DM) and obesity are known risk factors for poor outcomes in patients with systemic malignancies but are not well-studied in the brain tumor population. In this study we asked if type 2 DM and elevated body mass index (BMI) are independent risk factors for poor prognosis in patients with high-...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Chambless LB,Parker SL,Hassam-Malani L,McGirt MJ,Thompson RC

    更新日期:2012-01-01 00:00:00

  • Transient cerebral hypoperfusion assisted intraarterial cationic liposome delivery to brain tissue.

    abstract::Transient cerebral hypoperfusion (TCH) has empirically been used to assist intraarterial (IA) drug delivery to brain tumors. Transient (<3 min) reduction of cerebral blood flow (CBF) occurs during many neuro- and cardiovascular interventions and has recently been used to better target IA drugs to brain tumors. In the ...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Joshi S,Singh-Moon RP,Wang M,Chaudhuri DB,Holcomb M,Straubinger NL,Bruce JN,Bigio IJ,Straubinger RM

    更新日期:2014-05-01 00:00:00

  • Correction to: International experience in the development of patient-derived xenograft models of diffuse intrinsic pontine glioma.

    abstract::There are two errors and one omission in the original article. Author Gottardo's correct name is Nicholas G. Gottardo, author Hulleman's correct affiliation is no. 3 (VUMC, Amsterdam), and the Acknowledgements should include the following sentence: "We would like to thank Dr Angel Montero Carcaboso (Hospital Sant Joan...

    journal_title:Journal of neuro-oncology

    pub_type: 已发布勘误


    authors: Tsoli M,Shen H,Mayoh C,Franshaw L,Ehteda A,Upton D,Carvalho D,Vinci M,Meel MH,van Vuurden D,Plessier A,Castel D,Drissi R,Farrell M,Cryan J,Crimmins D,Caird J,Pears J,Francis S,Ludlow LEA,Carai A,Mastronuzzi A,

    更新日期:2019-01-01 00:00:00

  • p38 MAPK inhibitors attenuate pro-inflammatory cytokine production and the invasiveness of human U251 glioblastoma cells.

    abstract::Increasing evidence suggests that an inflammatory microenvironment promotes invasion by glioblastoma (GBM) cells. Together with p38 mitogen-activated protein kinase (MAPK) activation being regarded as promoting inflammation, we hypothesized that elevated inflammatory cytokine secretion and p38 MAPK activity contribute...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Yeung YT,Bryce NS,Adams S,Braidy N,Konayagi M,McDonald KL,Teo C,Guillemin GJ,Grewal T,Munoz L

    更新日期:2012-08-01 00:00:00

  • Characterization of intracranial space-occupying lesions by ⁹⁹(m)Tc-Tetrofosmin SPECT.

    abstract::Differentiating neoplastic from non-neoplastic intracranial lesions is of paramount importance for patient management. Benign lesions can have many of the features of malignant brain tumors on both computed tomography (CT) and conventional magnetic resonance imaging (MRI). Herewith, we set out to investigate the role ...

    journal_title:Journal of neuro-oncology

    pub_type: 临床试验,杂志文章


    authors: Fotopoulos AD,Kyritsis AP,Tsiouris S,Al-Boucharali J,Papadopoulos A,Voulgaris S,Alexiou GA

    更新日期:2011-01-01 00:00:00

  • Studies on estrogen induced pituitary tumor in the rat with special reference to the relationship of the tuberoinfundibular dopamine neuron system.

    abstract::Pituitary tumors were experimentally induced in female Wistar rats by repeated injections of estradiol dipropionate. The hypothalamus and pituitary tumors were studied simultaneously by fluorescence histochemistry and immunohistochemistry. The pituitary gland became larger with a concomitant increase of serum prolacti...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Fujimoto M,Yoshino E,Hirakawa K,Chihara K,Ibata Y

    更新日期:1987-01-01 00:00:00

  • Gliomatosis cerebri: clinical characteristics, management, and outcomes.

    abstract::Gliomatosis cerebri is a rare diffusely infiltrating primary neoplastic glial process of the brain. Our objective is to review clinical presentation, management, and outcome in a large single institution series of gliomatosis cerebri patients. 54 consecutive gliomatosis cerebri cases presenting to Mayo Clinic Rocheste...

    journal_title:Journal of neuro-oncology

    pub_type: 临床试验,杂志文章


    authors: Chen S,Tanaka S,Giannini C,Morris J,Yan ES,Buckner J,Lachance DH,Parney IF

    更新日期:2013-04-01 00:00:00

  • Extraneural metastatic medulloblastoma in an adult.

    abstract::Medulloblastoma is a rare malignancy in adults, accounting for approximately 1% of all primary brain tumors. Extraneural metastases have been reported in 10-30% of cases and most commonly involve bone; rarely lymph nodes, visceral organs and bone marrow may be involved with disease. We report here our experience with ...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Wendland MM,Shrieve DC,Watson GA,Chin SS,Blumenthal DT

    更新日期:2006-06-01 00:00:00

  • Impact of tumor location and pathological discordance on survival of children with midline high-grade gliomas treated on Children's Cancer Group high-grade glioma study CCG-945.

    abstract::Children with high-grade glioma (HGG) have a poor prognosis compared to those with low-grade glioma (LGG). Adjuvant chemotherapy may be beneficial, but its optimal use remains undetermined. Histology and extent of resection are important prognostic factors. We tested the hypothesis that patients with midline HGG treat...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章,随机对照试验


    authors: Eisenstat DD,Pollack IF,Demers A,Sapp MV,Lambert P,Weisfeld-Adams JD,Burger PC,Gilles F,Davis RL,Packer R,Boyett JM,Finlay JL

    更新日期:2015-02-01 00:00:00

  • Tubular brain tumor biopsy improves diagnostic yield for subcortical lesions.

    abstract:PURPOSE:Molecular data has become an essential part of the updated World Health Organization (WHO) grading of central nervous system tumors. However, stereotactic needle biopsies provide only small volume specimens and limit the extent of histologic and molecular testing that can be performed. We assessed the use of a ...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Bander ED,Jones SH,Pisapia D,Magge R,Fine H,Schwartz TH,Ramakrishna R

    更新日期:2019-01-01 00:00:00

  • Combined intracavitary thermotherapy with iron oxide nanoparticles and radiotherapy as local treatment modality in recurrent glioblastoma patients.

    abstract:BACKGROUND:There is an increasing interest in local tumor ablative treatment modalities that induce immunogenic cell death and the generation of antitumor immune responses. METHODS:We report six recurrent glioblastoma patients who were treated with intracavitary thermotherapy after coating the resection cavity wall wi...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Grauer O,Jaber M,Hess K,Weckesser M,Schwindt W,Maring S,Wölfer J,Stummer W

    更新日期:2019-01-01 00:00:00

  • Diffusion abnormalities of the corpus callosum in patients receiving bevacizumab for malignant brain tumors: suspected treatment toxicity.

    abstract::Bevacizumab has been reported to cause diffusion restriction in the tumor bed of patients with malignant gliomas. This study evaluated prolonged diffusion restriction, in the corpus callosum (CC), of patients with malignant brain tumors treated with bevacizumab. We retrospectively reviewed our database of patients tre...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Futterer SF,Nemeth AJ,Grimm SA,Ragin AB,Chandler JP,Muro K,Marymont MH,Raizer JJ

    更新日期:2014-05-01 00:00:00

  • Inpatient and outpatient case prioritization for patients with neuro-oncologic disease amid the COVID-19 pandemic: general guidance for neuro-oncology practitioners from the AANS/CNS Tumor Section and Society for Neuro-Oncology.

    abstract::The Coronavirus pandemic has created unprecedented strain on medical resources at health care institutions around the world. At many institutions, this has resulted in efforts to prioritize cases with an attempt to balance the acuity of medical needs with available resources. Here, we provide a framework for instituti...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Ramakrishna R,Zadeh G,Sheehan JP,Aghi MK

    更新日期:2020-05-01 00:00:00

  • A comparative analysis of EGFR mutation status in association with the efficacy of TKI in combination with WBRT/SRS/surgery plus chemotherapy in brain metastasis from non-small cell lung cancer.

    abstract::We proposed to identify the efficacy of an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) using whole brain radiotherapy (WBRT)/stereotactic radiosurgery (SRS)/surgery in brain metastases from patients with non-small cell lung cancer (NSCLC) and clarify the association between treatment outcom...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Cai L,Zhu JF,Zhang XW,Lin SX,Su XD,Lin P,Chen K,Zhang LJ

    更新日期:2014-11-01 00:00:00

  • Adding DSC PWI and DWI to BT-RADS can help identify postoperative recurrence in patients with high-grade gliomas.

    abstract:BACKGROUND:The Brain Tumor Reporting and Data System (BT-RADS) category 3 is suitable for identifying cases with intermediate probability of tumor recurrence that do not meet the Response Assessment in Neuro-Oncology (RANO) criteria for progression. The aim of this study was to evaluate the added value of dynamic susce...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Yang Y,Yang Y,Wu X,Pan Y,Zhou D,Zhang H,Chen Y,Zhao J,Mo Z,Huang B

    更新日期:2020-01-01 00:00:00

  • The effect of WHO reclassification of necrotic anaplastic oligoastrocytomas on incidence and survival in glioblastoma.

    abstract::In 2007 the WHO Classification of Tumours of the Central Nervous System introduced the entity "glioblastoma with oligodendroglioma component" (GBM/OLIGO). This entity accounts for approximately one in every ten new glioblastomas (GBM). In practice, those mixed gliomas with necrosis which were previously diagnosed as a...

    journal_title:Journal of neuro-oncology

    pub_type: 评论,杂志文章


    authors: Marucci G

    更新日期:2011-09-01 00:00:00

  • Effects of slice thickness and head rotation when measuring glioma sizes on MRI: in support of volume segmentation versus two largest diameters methods.

    abstract::This paper presents a study of the effects of scanning parameters variability when assessing glioma sizes on MRI. A database of lesions of various shapes and sizes, segmented on 3D-SPGR MRI images, was acquired on 65 patients with low-grade glioma. Simulations of large slice thickness and patient's head rotation were ...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Schmitt P,Mandonnet E,Perdreau A,Angelini ED

    更新日期:2013-04-01 00:00:00

  • TERT promoter mutations and rs2853669 polymorphism: prognostic impact and interactions with common alterations in glioblastomas.

    abstract::TERT promoter (TERTp) mutation is the most common mutation in glioblastomas. It creates a putative binding site for Ets/TCF transcription factors, enhancing telomerase expression and activity, whereas the rs2853669 variant disrupts another Ets/TCF binding. We explore here the interaction between these two alterations,...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Nencha U,Rahimian A,Giry M,Sechi A,Mokhtari K,Polivka M,Schmitt Y,Di Stefano AL,Alentorn A,Labussière M,Sanson M

    更新日期:2016-02-01 00:00:00

  • Early vs. delayed radiotherapy in a small cohort of patients with supratentorial low grade glioma.

    abstract::In a cohort of 25 patients with supratentorial low grade glioma, the timing of radiotherapy made no significance difference for 10 year survival. Patients who received early radiotherapy had a 55% 10 year survival and those receiving delayed radiotherapy had a 53% 10 year survival. Radiotherapy was delayed a median of...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Knisely JP,Haffty BG,Christopher SR

    更新日期:1997-08-01 00:00:00

  • Disparities in glioblastoma survival by case volume: a nationwide observational study.

    abstract:INTRODUCTION:High hospital case volumes are associated with improved treatment outcomes for numerous diseases. We assessed the association between academic non-profit hospital case volume and survival of adult glioblastoma patients. METHODS:From the nationwide Finnish Cancer Registry, we identified all adult (≥ 18 yea...

    journal_title:Journal of neuro-oncology

    pub_type: 杂志文章


    authors: Raj R,Seppä K,Luostarinen T,Malila N,Seppälä M,Pitkäniemi J,Korja M

    更新日期:2020-04-01 00:00:00