Advances in the surgical treatment of speech-eloquent gliomas

Contemporary glioma surgery follows the maxim of maximal safe resection, with the goal of cytoreduction balanced by maintenance of neurologic function. Consistent data has shown that gross total resection, defined as complete removal of overt tumor identified on MRI, results in decreased 1- and 2-year mortality and 6- and 12-month disease-free progression as compared to subtotal resections. On the other hand, sparing function is of high priority for providers and patients as preservation of motor, visual, and language functions significantly improves the quality of life and even extensive surgery is not curative. Brain mapping serves as the tool by which neurosurgeons can optimize this onco-functional balance.