The Role of Intracranial Surgery for the Treatment of Malignant Gliomas

Abstract

The malignant glioma, grades III and IV, is a cancer of rare biological consistency which until the advent of recent therapeutic advances had a median survival time of 6 months and killed 90% in 18 months [1]. There are 385,000 deaths from cancer each year in the USA of which 50,000 (13%) are associated with central nervous system involvement. It is estimated that of the 50,000 deaths, 8,500 (17%) are caused by primary brain tumors and 5,000 of these can be attributed to the malignant glioma or glioblastoma. The number of deaths from malignant gliomas is about half those reported from leukemia but are, in fact, more common than those from Hodgkin’s disease [2]. At the New York University Medical Center in the last 1,000 surgically verified primary supratentorial tumors in adults, 500 represent tumors of glial origin. Eighty percent of glial tumors were in the malignant glioma and glioblastoma class, 10% in the grade I, II and mixed glial groups and 10% represented oligodendrogliomas, ependymomas and other less common forms of primary tumors of neural origin.