ReviewAnnals of medicine and surgery (2012)2026
Supramaximal resection in gliomas: a narrative review of surgical techniques, clinical outcomes, and ethical considerations.
Review in Annals of medicine and surgery (2012), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Supramaximal resection (SMR) represents an evolving frontier in glioma surgery, extending tumor removal beyond conventional contrast-enhancing margins on magnetic resonance imaging (MRI) to include infiltrative, non-contrast-enhancing regions. Rooted in the understanding that gliomas spread microscopically beyond visible boundaries, SMR aims not only to delay recurrence but also to meaningfully prolong survival while preserving neurological integrity. Objective: This narrative review explores the conceptual foundations, surgical innovations, clinical outcomes, and ethical dimensions surrounding SMR in the management of diffuse gliomas. Methods: A structured review of the literature published between 2005 and 2025 was conducted across major medical databases. Search terms included "supramaximal resection," "supratotal resection," "glioma," "5-ALA," "intraoperative MRI," "direct electrical stimulation," "tractography," and "connectomics." Clinical trials, prospective and retrospective cohorts, and systematic reviews were synthesized to evaluate oncological benefits, functional outcomes, and practical feasibility. Results: Although definitions of SMR remain heterogeneous, advances in awake craniotomy, cortical and subcortical mapping, intraoperative MRI, fluorescence-guided surgery, and connectome-informed planning have redefined the boundaries of safe resection. Emerging evidence, primarily levels II-III, suggests that extending resection into FLAIR abnormalities beyond the contrast-enhancing tumor may improve overall and progression-free survival, particularly in selected high-grade gliomas. Importantly, functional mapping techniques allow surgeons to pursue oncologic maximization without disproportionately increasing permanent neurological deficits. Conclusion: SMR reflects a shift from purely anatomical resection toward function-guided precision surgery. While promising, its adoption requires standardized definitions, prospective validation, and careful shared decision-making. Ultimately, the goal of SMR is not only longer survival but survival lived with preserved cognition, independence, and dignity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.