AWAKE CRANIOTOMY FOR PATIENTS WITH RECURRENT GLIOMAS. A REVIEW OF LITERATURE
Keywords:
recurrent glioma, neurophysiological mapping, awake surgeryAbstract
This systematic review was conducted according to the PRISMA 2020 guidelines to identify English-language studies published within the past 5 years (2020–2025) reporting awake craniotomy (with intraoperative mapping) for repeat resection of recurrent glioblastoma in adult patients (≥18 years). PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched. We included retrospective or prospective series with ≥3 patients and excluded techniques performed in a non-awake state, histology other than glioblastoma, non-recurrent resections, and publications not in English. Extracted data included sample size, mapping success, resection extent (EOR/GTR), neurological deficit rate (transient/permanent), PFS, OS, and follow-up duration. Specifically, we focused on articles in which authors evaluated and compared the risk-benefit ratio of awake surgery for recurrent cases. Only articles in English were analyzed.
Results: A search of the current literature identified 340 records (original articles and case series). After removing 46 duplicates, 294 records were screened by title/ANNOTATION, of which 250 were excluded. Forty-four full-text articles were assessed for inclusion criteria; 36 were excluded (20 due to non-recurrent glioblastoma, 8 due to insufficient data, 4 due to duplicate datasets, and 4 due to non-English language). Ultimately, 8 studies met the inclusion criteria for qualitative synthesis; of these, 5 provided sufficient data for quantitative synthesis (meta-analysis).
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