SynthesisJournal of neuro-oncology2026
Awake surgery versus general anesthesia in the treatment of Diffuse Low-Grade Gliomas - and the role of supplementary intraoperative techniques: a systematic review and meta-analysis.
Synthesis in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
11 authors.
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Abstract
purposeAwake surgery (AS) has emerged as a valuable alternative to surgery under general anesthesia (GA) in the treatment of Diffuse Low Grade Gliomas (DLGGs). Despite the growing body of literature supporting AS in glioma surgery, no meta-analysis has yet specifically addressed its efficacy and safety in the treatment of DLGGs. We conducted a meta-analysis of cranial comparing AS and GA in treatment of DLGGs.
methodsWe systematically reviewed the literature from PubMed, Embase, and Cochrane databases. The outcomes of interest were overall survival (OS), extent of resection (EOR), and immediate and long-term postoperative neurofunctional deficits (PNDs). Statistical analysis was performed using Review Manager 5.4.1.
results12 studies were included, with 895 patients, 464 (51.84%) in the AS group, and a mean follow-up of 47.22 ± 55.52 months. At 5 years, AS was associated with a 28% higher OS (p = 0.006; I² = 32%). In the comparison without supplementary intraoperative techniques (SIT), AS demonstrated a mean EOR over 30% higher (p < 0.0001; I² = 81%). Regarding long-term PNDs, AS significantly reduced risk, with a 72% lower risk overall (p < 0.0001; I² = 0%) and a 70% lower risk in the subgroup without SIT (p = 0.0003; I² = 0%). No statistically significant differences were observed in other analyses.
conclusionIn the pursuit of achieving the best oncological-functional balance for patients, AS emerges as a preferable option for the treatment of DLGGs. Despite these relevant findings, caution is warranted in interpreting the results due to the limitations of the included studies.
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