Evidence map›Paper›PMID 39657577›Full record

ArticleNeuro-oncology2025

Neuro-oncological superiority of supratotal resection in lower-grade gliomas.

Alberto L Gallotti, Marco Rossi, Marco Conti Nibali, Tommaso Sciortino, Lorenzo G Gay, Guglielmo Puglisi, Antonella Leonetti, Francesco Bruno, Roberta Rudà, Riccardo Soffietti and 2 more

Abstract read
In one paragraph

Article in Neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Alberto L GallottiDepartment of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milano, Italy.ORCID 0000-0001-9698-7919
Marco RossiDepartment of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy.ORCID 0000-0002-0196-2370
Marco Conti NibaliNeurosurgery Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milano, Italy.
Tommaso SciortinoNeurosurgery Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milano, Italy.
Lorenzo G GayNeurosurgery Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milano, Italy.
Guglielmo PuglisiDepartment of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy.
Antonella LeonettiDepartment of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy.
Francesco BrunoDivision of Neuro-Oncology, Department of Neuroscience, Università degli Studi di Torino, Torino, Italy.ORCID 0000-0001-8087-5293
Roberta RudàDivision of Neuro-Oncology, Department of Neuroscience, Università degli Studi di Torino, Torino, Italy.ORCID 0000-0001-9134-1537
Riccardo SoffiettiDivision of Neuro-Oncology, Department of Neuroscience, Università degli Studi di Torino, Torino, Italy.ORCID 0000-0002-9204-7038
Gabriella CerriDepartment of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milano, Italy.
Lorenzo BelloDepartment of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milano, Italy.

Funding

Associazione Italiana Ricerca sul Cancro 17842Associazione Italiana Ricerca sul Cancro 27184
6 · The paper itself

Abstract

backgroundSupratotal-resection (SpTR) is a promising surgical strategy in lower-grade gliomas (LGGs). SpTR assessment, feasibility and distinctive features, as well as clinical benefit at first and second surgery and on overall survival must be better characterized. The critical percentage of resection exceeding FLAIR margins to obtain clinical benefit and its impact on long-term functional performance are also undefined.

methodsIncluded were 704 patients with primary and 439 with recurrent LGGs seen between 2010 and 2019, who underwent resection with brain-mapping technique (BMT) aimed at achieving a SpTR without any "a-priori" selection. Extent-of-resection, evaluated on 3D-FLAIR-MR and categorized according to residual tumor and cavity volume, was associated with progression-free survival (PFS) and malignant(M)PFS at first and second surgery and overall survival by univariate, multivariate, and propensity-score analysis. Functional performance was assessed by neuropsychological (NPS) evaluation.

resultsSpTR evaluation requires volumetric assessment enhanced by brain deformation measurement in parietal tumors; SpTR rate accounts on average for 50.2% and 35.7% at first and second surgery is higher in grade-2, frontal, and temporal locations (at expenses of total resection [TR]). Compared to TR, SpTR reduces and postpones first and second recurrences in all molecular subtypes and grades, delays MPFS without difference in rate, and prolongs overall survival (OS). A degree of SpTR > 120% associates with the lowest recurrence risk. SpTR associates with the best NPS longitudinal course.

conclusionsThis study supports the feasibility of SpTR in LGGs, its benefit at first and second surgery regardless of molecular subtypes, and on OS, significantly reducing recurrence when SpTR > 120%; SpTR also associates with the best patients' functional outcome.

Indexed as

Brain NeoplasmsGliomaNeoplasm Recurrence, LocalNeurosurgical ProceduresAdolescentAdultAgedBrain MappingFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedNeoplasm GradingPrognosislower-grade gliomasneuropsychological evaluationoverall survivalrecurrencesupratotal resection

Identifiers

PMID39657577
PMCPMC12187370

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.