NT-27 * SURGICAL RESECTION OF THALAMIC MALIGNANT GLIOMA

Abstract

PURPOSE: Thalamus has important functions, such as a role of a relay point which connects somatic and motor signals to the cerebral cortex, and regulation of alertness. Thus, gross total resection of the glioma arising from the thalamus is thought to be harmful, and an operation should be limited to biopsy for histological diagnosis. Recently, we attempted to resect thalamic gliomas based on tractography derived from DTI to identify internal capsule, and spare eloquent areas in the thalamus during resection. METHODS: Four patients with thalamic malignant glioma underwent surgical resection via transparietal transventricular approach between 2008 and 2013. Resection rate, pre- and postoperative status of the patients, distance between internal capsule and tumor, progression-free survival and overall survival time were retrospectively reviewed. RESULTS: Histological diagnosis of all patients was glioblastoma. 2 patients were symptom-free after surgery. Rest of 2 patients had mild hemiparesis postopertively, and one patient required cane for the walk. All tumors were located in the right thalamus. The distance between internal capsule and tumor was more than 5mm in patients without postoperative neurological deficit. Gross total resection of the tumor was achieved in 3 patients, and near-total resection (<95%) of the tumor was performed in one patient. Progression-free survival of these patients was 47.4 weeks, and overall survival was 81.5 weeks. CONCLUSION: Thalamic malignant gliomas were able to be resected more than 95% with acceptable morbidity.