Introduction: Glioblastoma: an update on pathophysiology and management strategies

摘要

Glioblastoma multiforme remains an enigma for neurooncology; our understanding has progressed, but the prognosis is still poor. In this issue of Neurosurgical Focus, the emphasis is on presenting current understanding of the pathophysiology of the disease and the management strategies that stem from it. The issue can be divided into current management strategies and future treatments based on recent advances in understanding glioblastoma pathophysiology, including cancer stem cells, angiogenesis, and tumor heterogeneity. The first part of the issue is devoted to an evaluation of treatment methods available to patients today. From an operative standpoint, Hawasli et al. present a timely article on the use of stereotactic laser ablation of high-grade gliomas, a procedure that is available to most neurosurgeons using the current armamentarium of imaging and ablative equipment. Lescher and colleagues assert that the time frame for the evaluation of postoperative changes versus residual tumor is important in determining the extent of resection, given increasing data showing survival benefits with radiographically gross- or near-total resections. From a medical perspective, Barbagallo et al. report data on long-term treatment with temozolomide, whereas Pompili et al. describe palliative care and end of life issues for patients with glioblastoma. The second part of this issue emphasizes the role of future treatments that will stem from recent advances in understanding the pathophysiology of glioblastoma multiforme. Sundar et al. present a timely review on the role of cancer stem cells in glioblastoma, which is followed by Khan and Ehteshams article on treatment based on targeting glioma stem cells.