Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project

Susan M. Chang Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Susan M. Chang in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Ian F. Parney Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Ian F. Parney in
Current site
Google Scholar
PubMed
Close
 M.D., Ph.D.
,
Michael Mcdermott Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Michael Mcdermott in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Fred G. Barker II Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Fred G. Barker II in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Meic H. Schmidt Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Meic H. Schmidt in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Wei Huang Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Wei Huang in
Current site
Google Scholar
PubMed
Close
 M.S.
,
Edward R. Laws Jr. Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Edward R. Laws Jr. in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Kevin O. Lillehei Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Kevin O. Lillehei in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Mark Bernstein Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Mark Bernstein in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Henry Brem Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Henry Brem in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Andrew E. Sloan Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Andrew E. Sloan in
Current site
Google Scholar
PubMed
Close
 M.D.
,
Mitchel Berger Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by Mitchel Berger in
Current site
Google Scholar
PubMed
Close
 M.D.
, and
the Glioma Outcomes Investigators Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California; Brain Tumor Center, Massachusetts General Hospital and Harvard University; Center for Outcomes Research, University of Massachusetts Medical School, Boston, Massachusetts; Department of Neurosurgery, University of Utah, Salt Lake City, Utah; Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia; Division of Neurosurgery, University of Colorado, Denver, Colorado; Division of Neurosurgery, University of Toronto, Ontario, Canada; Departments of Neurosurgery and Oncology, The Johns Hopkins University, Baltimore, Maryland; and Department of Neurological Surgery, Wayne State University, Detroit, Michigan

Search for other papers by the Glioma Outcomes Investigators in
Current site
Google Scholar
PubMed
Close
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $536.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $636.00
USD  $45.00
USD  $536.00
USD  $636.00
Print or Print + Online Sign in

Object. In many new clinical trials of patients with malignant gliomas surgical intervention is incorporated as an integral part of tumor-directed interstitial therapies such as gene therapy, biodegradable wafer placement, and immunotherapy. Assessment of toxicity is a major component of evaluating these novel therapeutic interventions, but this must be done in light of known complication rates of craniotomy for tumor resection. Factors predicting neurological outcome would also be helpful for patient selection for surgically based clinical trials.

Methods. The Glioma Outcome Project is a prospectively compiled database containing information on 788 patients with malignant gliomas that captured clinical practice patterns and patient outcomes. Patients in this series who underwent their first or second craniotomy were analyzed separately for presenting symptoms, tumor and patient characteristics, and perioperative complications. Preoperative and intraoperative factors possibly related to neurological outcome were evaluated.

There were 408 patients who underwent first craniotomies (C1 group) and 91 patients who underwent second ones (C2 group). Both groups had similar patient and tumor characteristics except for their median age (55 years in the C1 group compared with 50 years in the C2 group; p = 0.006). Headache was more common at presentation in the C1 group, whereas papilledema and an altered level of consciousness were more common at presentation in patients undergoing second surgeries. Perioperative complications occurred in 24% of patients in the C1 group and 33% of patients in the C2 group (p = 0.1). Most patients were the same or better neurologically after surgery, but more patients in the C2 group (18%) displayed a worsened neurological status than those in the C1 group (8%; p = 0.007). The Karnofsky Performance Scale score and, in patients in the C2 group, tumor size were important neurological outcome predictors. Regional complications occurred at similar rates in both groups. Systemic infections occurred more frequently in the C2 group (4.4 compared with 0%; p < 0.0001) as did depression (20 compared with 11%; p = 0.02). The perioperative mortality rate was 1.5% for the C1 group and 2.2% for the C2 group (p = not significant). The median length of the hospital stay was 4 days in each group.

Conclusions. Perioperative complications occur slightly more often following a second craniotomy for malignant glioma than after the first craniotomy. This should be considered when evaluating toxicities from intraoperative local therapies requiring craniotomy. Nevertheless, most patients are neurologically stable or improved after either their first or second craniotomy. This data set may serve as a benchmark for neurosurgeons and others in a discussion of operative risks in patients with malignant gliomas.

  • Collapse
  • Expand
  • 1.

    Ammirati M, , Galicich JH, & Arbit E, et al: Reoperation in the treatment of recurrent intracranial malignant gliomas. Neurosurgery 21:607614, 1987 Ammirati M, Galicich JH, Arbit E, et al: Reoperation in the treatment of recurrent intracranial malignant gliomas. Neurosurgery 21:607–614, 1987

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Anderson SI, , Taylor R, & Whittle IR: Mood disorders in patients after treatment for primary intracranial tumours. Br J Neurosurg 13:480485, 1999 Anderson SI, Taylor R, Whittle IR: Mood disorders in patients after treatment for primary intracranial tumours. Br J Neurosurg 13:480–485, 1999

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Barker FG II, , Chang SM, & Gutin PH, et al: Survival and functional status after resection of recurrent glioblastoma multiforme. Neurosurgery 42:709723, 1998 Barker FG II, Chang SM, Gutin PH, et al: Survival and functional status after resection of recurrent glioblastoma multiforme. Neurosurgery 42:709–723, 1998

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Blanshard HJ, , Chung F, & Manninen PH, et al: Awake craniotomy for removal of intracranial tumor: considerations for early discharge. Anesth Analg 92:8994, 2001 Blanshard HJ, Chung F, Manninen PH, et al: Awake craniotomy for removal of intracranial tumor: considerations for early discharge. Anesth Analg 92:89–94, 2001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Bohinski RJ, , Kokkino AK, & Warnick RE, et al: Glioma resection in a shared-resource magnetic resonance operating room after optimal image-guided frameless stereotactic resection. Neurosurgery 48:731744, 2001 Bohinski RJ, Kokkino AK, Warnick RE, et al: Glioma resection in a shared-resource magnetic resonance operating room after optimal image-guided frameless stereotactic resection. Neurosurgery 48:731–744, 2001

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Brell M, , Ibanez J, & Caral L, et al: Factors influencing surgical complications of intra-axial brain tumors. Acta Neurochir 142:739750, 2000 Brell M, Ibanez J, Caral L, et al: Factors influencing surgical complications of intra-axial brain tumors. Acta Neurochir 142:739–750, 2000

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Brem H, , Piantadosi S, & Burger PC, et al: Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. The Polymer-brain Tumor Treatment Group. Lancet 345:10081012, 1995 Brem H, Piantadosi S, Burger PC, et al: Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. The Polymer-brain Tumor Treatment Group. Lancet 345:1008–1012, 1995

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Cabantog AM, & Bernstein M: Complications of first craniotomy for intra-axial brain tumour. Can J Neurol Sci 21:213218, 1994 Cabantog AM, Bernstein M: Complications of first craniotomy for intra-axial brain tumour. Can J Neurol Sci 21:213–218, 1994

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Ciric I, , Ammirati M, & Vick N, et al: Supratentorial gliomas: surgical considerations and immediate postoperative results. Gross total resection versus partial resection. Neurosurgery 21:2126, 1987 Ciric I, Ammirati M, Vick N, et al: Supratentorial gliomas: surgical considerations and immediate postoperative results. Gross total resection versus partial resection. Neurosurgery 21:21–26, 1987

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Curran WJ Jr, , Scott CB, & Horton J, et al: Does extent of surgery influence outcome for astrocytoma with atypical or anaplastic foci (AAF)? A report from three Radiation Therapy Oncology Group (RTOG) trials. J Neurooncol 12:219227, 1992 Curran WJ Jr, Scott CB, Horton J, et al: Does extent of surgery influence outcome for astrocytoma with atypical or anaplastic foci (AAF)? A report from three Radiation Therapy Oncology Group (RTOG) trials. J Neurooncol 12:219–227, 1992

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Devaux BC, , O'Fallon JR, & Kelly PJ: Resection, biopsy, and survival in malignant glial neoplasms. A retrospective study of clinical parameters, therapy, and outcome. J Neurosurg 78:767775, 1993 Devaux BC, O'Fallon JR, Kelly PJ: Resection, biopsy, and survival in malignant glial neoplasms. A retrospective study of clinical parameters, therapy, and outcome. J Neurosurg 78:767–775, 1993

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Fadul C, , Wood J, & Thaler H, et al: Morbidity and mortality of craniotomy for excision of supratentorial gliomas. Neurology 38:13741379, 1988 Fadul C, Wood J, Thaler H, et al: Morbidity and mortality of craniotomy for excision of supratentorial gliomas. Neurology 38:1374–1379, 1988

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Halligan JB, , Stelzer KJ, & Rostomily RC, et al: Operation and permanent low activity 125I brachytherapy for recurrent high-grade astrocytomas. Int J Radiat Oncol Biol Phys 35:541547, 1996 Halligan JB, Stelzer KJ, Rostomily RC, et al: Operation and permanent low activity 125I brachytherapy for recurrent high-grade astrocytomas. Int J Radiat Oncol Biol Phys 35:541–547, 1996

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Haroun RI, & Brem H: Local drug delivery. Curr Opin Oncol 12:187193, 2000 Haroun RI, Brem H: Local drug delivery. Curr Opin Oncol 12:187–193, 2000

  • 15.

    Harsh GR IV, , Levin VA, & Gutin PH, et al: Reoperation for recurrent glioblastoma and anaplastic astrocytoma. Neurosurgery 21:615621, 1987 Harsh GR IV, Levin VA, Gutin PH, et al: Reoperation for recurrent glioblastoma and anaplastic astrocytoma. Neurosurgery 21:615–621, 1987

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Jackson RJ, , Fuller GN, & Abi-Said D, et al: Limitations of stereotactic biopsy in the initial management of gliomas. Neuro-oncol 3:193200, 2001 Jackson RJ, Fuller GN, Abi-Said D, et al: Limitations of stereotactic biopsy in the initial management of gliomas. Neuro-oncol 3:193–200, 2001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Kaibara T, , Saunders JK, & Sutherland GR: Advances in mobile intraoperative magnetic resonance imaging. Neurosurgery 47:131138, 2000 Kaibara T, Saunders JK, Sutherland GR: Advances in mobile intraoperative magnetic resonance imaging. Neurosurgery 47:131–138, 2000

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Karnofsky DA, & Burchenal JH: The clinical evaluation of chemotherapeutic agents in cancer, in MacLeod CM (ed): Evaluation of Chemotherapeutic Agents. New York: Columbia University Press, 1949, p 196 Karnofsky DA, Burchenal JH: The clinical evaluation of chemotherapeutic agents in cancer, in MacLeod CM (ed): Evaluation of Chemotherapeutic Agents. New York: Columbia University Press, 1949, p 196

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Kleihues P, , Burger PC, & Scheithauer BW: Histological Typing of Tumours of the Central Nervous System. Berlin: Springer-Verlag, 1993 Kleihues P, Burger PC, Scheithauer BW: Histological Typing of Tumours of the Central Nervous System. Berlin: Springer-Verlag, 1993

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Koot RW, , Maarouf M, & Hulshof MC, et al: Brachytherapy: results of two different therapy strategies for patients with primary glioblastoma multiforme. Cancer 88:27962802, 2000 Koot RW, Maarouf M, Hulshof MC, et al: Brachytherapy: results of two different therapy strategies for patients with primary glioblastoma multiforme. Cancer 88:2796–2802, 2000

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Kreth FW, , Warnke PC, & Scheremet R, et al: Surgical resection and radiation therapy versus biopsy and radiation therapy in the treatment of glioblastoma multiforme. J Neurosurg 78:762766, 1993 Kreth FW, Warnke PC, Scheremet R, et al: Surgical resection and radiation therapy versus biopsy and radiation therapy in the treatment of glioblastoma multiforme. J Neurosurg 78:762–766, 1993

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Lacroix M, , Abi-Said D, & Fourney DR, et al: A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 95:190198, 2001 Lacroix M, Abi-Said D, Fourney DR, et al: A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 95:190–198, 2001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Landy HJ, , Feun L, & Schwade JG, et al: Retreatment of intracranial gliomas. South Med J 87:211214, 1994 Landy HJ, Feun L, Schwade JG, et al: Retreatment of intracranial gliomas. South Med J 87:211–214, 1994

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Meyer FB, , Bates LM, & Goerss SJ, et al: Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clin Proc 76:677687, 2001 Meyer FB, Bates LM, Goerss SJ, et al: Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clin Proc 76:677–687, 2001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Reardon DA, , Akabani G, & Coleman RE, et al: Phase II trial of murine (131)I-labeled antitenascin monoclonal antibody 81C6 administered into surgically created resection cavities of patients with newly diagnosed malignant gliomas. J Clin Oncol 20:13891397, 2002 Reardon DA, Akabani G, Coleman RE, et al: Phase II trial of murine (131)I-labeled antitenascin monoclonal antibody 81C6 administered into surgically created resection cavities of patients with newly diagnosed malignant gliomas. J Clin Oncol 20:1389–1397, 2002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Rostomily RC, , Berger MS, & Ojemann GA, et al: Postoperative deficits and functional recovery following removal of tumors involving the dominant hemisphere supplementary motor area. J Neurosurg 75:6268, 1991 Rostomily RC, Berger MS, Ojemann GA, et al: Postoperative deficits and functional recovery following removal of tumors involving the dominant hemisphere supplementary motor area. J Neurosurg 75:62–68, 1991

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Salcman M: Resection and reoperation in neuro-oncology. Rationale and approach. Neurol Clin 3:831842, 1985 Salcman M: Resection and reoperation in neuro-oncology. Rationale and approach. Neurol Clin 3:831–842, 1985

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Salcman M, , Kaplan RS, & Ducker TB, et al: Effect of age and reoperation on survival in the combined modality treatment of malignant astrocytoma. Neurosurgery 10:454463, 1982 Salcman M, Kaplan RS, Ducker TB, et al: Effect of age and reoperation on survival in the combined modality treatment of malignant astrocytoma. Neurosurgery 10:454–463, 1982

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Sawaya R, , Hammoud M, & Schoppa D, et al: Neurosurgical outcomes in a modern series of 400 craniotomies for treatment of parenchymal tumors. Neurosurgery 42:10441056, 1998 Sawaya R, Hammoud M, Schoppa D, et al: Neurosurgical outcomes in a modern series of 400 craniotomies for treatment of parenchymal tumors. Neurosurgery 42:1044–1056, 1998

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Schulder M, , Liang D, & Carmel PW: Cranial surgery navigation aided by a compact intraoperative magnetic resonance imager. J Neurosurg 94:936945, 2001 Schulder M, Liang D, Carmel PW: Cranial surgery navigation aided by a compact intraoperative magnetic resonance imager. J Neurosurg 94:936–945, 2001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Taylor MD, & Bernstein M: Awake craniotomy with brain mapping as the routine surgical approach to treating patients with supratentorial intraaxial tumors: a prospective trial of 200 cases. J Neurosurg 90:3541, 1999 Taylor MD, Bernstein M: Awake craniotomy with brain mapping as the routine surgical approach to treating patients with supratentorial intraaxial tumors: a prospective trial of 200 cases. J Neurosurg 90:35–41, 1999

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Taylor WA, , Thomas NW, & Wellings JA, et al: Timing of postoperative intracranial hematoma development and implications for the best use of neurosurgical intensive care. J Neurosurg 82:4850, 1995 Taylor WA, Thomas NW, Wellings JA, et al: Timing of postoperative intracranial hematoma development and implications for the best use of neurosurgical intensive care. J Neurosurg 82:48–50, 1995

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Vick NA, , Ciric IS, & Eller TW, et al: Reoperation for malignant astrocytoma. Neurology 39:430432, 1989 Vick NA, Ciric IS, Eller TW, et al: Reoperation for malignant astrocytoma. Neurology 39:430–432, 1989

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Vives KP, & Piepmeier JM: Complications and expected outcome of glioma surgery. J Neurooncol 42:289302, 1999 Vives KP, Piepmeier JM: Complications and expected outcome of glioma surgery. J Neurooncol 42:289–302, 1999

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Vorster SJ, & Barnett GH: A proposed preoperative grading scheme to asses risk for surgical resection of primary and secondary intraaxial supratentorial brain tumors. Neurosurg Focus 4 (6):Article 2, 1998 Vorster SJ, Barnett GH: A proposed preoperative grading scheme to asses risk for surgical resection of primary and secondary intraaxial supratentorial brain tumors. Neurosurg Focus 4 (6):Article 2, 1998

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Winger MJ, , Macdonald DR, & Cairncross JG: Supratentorial anaplastic gliomas in adults. The prognostic importance of extent of resection and prior low-grade glioma. J Neurosurg 71:487493, 1989 Winger MJ, Macdonald DR, Cairncross JG: Supratentorial anaplastic gliomas in adults. The prognostic importance of extent of resection and prior low-grade glioma. J Neurosurg 71:487–493, 1989

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Young B, , Oldfield EH, & Markesbery WR, et al: Reoperation for glioblastoma. J Neurosurg 55:917921, 1981 Young B, Oldfield EH, Markesbery WR, et al: Reoperation for glioblastoma. J Neurosurg 55:917–921, 1981

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 2366 641 145
Full Text Views 567 47 1
PDF Downloads 394 44 1
EPUB Downloads 0 0 0