Glioma Clinical Trial
Official title:
Supratotal Resection for Gliomas Within Noneloquent Areas: A Single Center Prospective Randomized Controlled Clinical Trial
Gliomas, especially high grade gliomas and diffuse low grade gliomas, are characterized by
their infiltrative nature. Recently, a new conception of supratotal resection has been
proposed. Given the lack of prospective supporting data, the correlation between supratotal
resection and the survival of patients with glioma need to be established.
Therefore, the investigators aim to do a single center prospective randomized controlled
clinical trial to assess the effect of supratotal resection at least 1 cm beyond the MR
imaging-defined abnormalities on progression-free survival (PFS) of glioma.
It has been demonstrated that an extensive resection (total or subtotal) significantly increases the overall survival in patients with gliomas. Yet, recent data have shown that conventional MR imaging underestimates the spatial extent of gliomas, since tumor cells were found to invade beyond MR imaging abnormalities. Thus, it is hypothesized that an extended resection with a margin beyond MR imaging-defined abnormalities—a "supratotal" resection—might improve the outcome of gliomas. However, the exact extent of supratotal resection remains unclear. Unnecessary removal of brain tissue that does not contain cancer cells can lead to neurological deficits that affect quality of life, such as impaired cognition, memory, and vision. Recently, studies from human specimens have shown that infiltrating glioma cells spread about 1cm beyond the gross and radiographic margins of the tumor. The investigators thereof propose to perform extended resection at least 1cm beyond the MRI defined margin might improve the outcome of patients with gliomas. ;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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