Original Article
Using cortical function mapping by awake
craniotomy dealing with the patient with recurrent
glioma in the eloquent cortex
Q6
Q5
Ying-Ching Li
a
, Hsiao-Yean Chiu
b
, Kuo-Chen Wei
a,c
, Ya-Jui Lin
d
,
Ko-Ting Chen
a
, Peng-Wei Hsu
a,c
, Yin-Cheng Huang
a,c
,
Pin-Yuan Chen
a,c,d,*
a
Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taiwan
b
School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
c
School of Medicine, Chang Gung University, Taoyuan, Taiwan
d
Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung, Taiwan
article info
Article history:
Received 17 January 2019
Accepted 5 June 2020
Available online xxx
Keywords:
Awake craniotomy
General anesthesia
Glioma
KPS
Glioblastoma
Neurologic deficits
abstract Q1
Background: Awake craniotomy is an effective method by which to reduce postoperative
neurologic deficit in newly-diagnosed glioma patients. However, the level of functional
preservation in patients undergoing resection of recurrent glioma remains unknown.
Therefore, this study aimed to evaluate functional outcomes in patients with recurrent
glioma undergoing awake craniotomy as compared with conservative general anesthesia
craniotomy for tumor resection. Q2
Material and methods: We retrospectively reviewed 225 patients who had recurrent gliomas
from May 2013 to January 2016 in our institution. New-onset neurological deficits were
evaluated on postoperative day 7 (early) and at 3 months (late). General performance was
assessed both preoperatively and at 3 months postoperatively.
Results: The early neurological deficit rate was 3.8% in the awake craniotomy group and
21.6% in the general anesthesia group (P ¼ 0.032), while the late neurological deficit rates
were 3.8% and 11.5%, respectively (P ¼ 0.231). Moreover, 46.1% of patients in the awake
craniotomy group and 12.6% in the general anesthesia group demonstrated an improve-
ment in the Karnofsky performance status (KPS) score (P < 0.001).
Conclusions: Awake craniotomy is an effective and safe method by which to perform
recurrent glioma surgery. The neurological outcomes and general performance after awake
craniotomy in recurrent glioma patients were better than those in patients undergoing
general anesthesia craniotomy.
* Corresponding author. Chang Gung Memorial Hospital, Taiwan.
E-mail address: pinyuanc@cgmh.org.tw (P.-Y. Chen).
Peer review under responsibility of Chang Gung University.
Available online at www.sciencedirect.com
ScienceDirect
Biomedical Journal
journal homepage: www.elsevier.com/locate/bj
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biomedical journal xxx (xxxx) xxx
BJ317_proof ■ 26 June 2020 ■ 1/6
https://doi.org/10.1016/j.bj.2020.06.004
2319-4170/© 2020 Chang Gung University. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND
license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Please cite this article as: Li Y-C et al., Using cortical function mapping by awake craniotomy dealing with the patient with recurrent
glioma in the eloquent cortex, Biomedical Journal, https://doi.org/10.1016/j.bj.2020.06.004