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Cancers
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Impact of Surgery on Brain Cancer and Other Central Nervous...
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Impact of Surgery on Brain Cancer and Other Central Nervous System Tumors

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 15 July 2025 | Viewed by 5794

Special Issue Editors

Dr. Paolo Tini

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Guest Editor
1. Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci, 16, 53100 Siena, Italy
2. Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, USA
Interests: brain tumors; stereotactic radiosurgery; radiobiology; combined treatments; gliomas; brain metastases; molecular markers
Special Issues, Collections and Topics in MDPI journals
Dr. Francesco Marampon

E-Mail Website
Guest Editor
Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
Interests: radiotherapy; radio-resistance; rhabdomyosarcoma; adult cancers; epigenetic drugs; targeted therapy; ERK functions; MYC
Special Issues, Collections and Topics in MDPI journals
Dr. Giuseppe Minniti

E-Mail Website
Guest Editor
1. Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
2. IRCCS Neuromed, Pozzilli, IS, Italy
Interests: neuro-oncology; radiotherapy in CNS cancers; radiosurgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In CNS oncological disease, surgery plays a key role in the treatment. Modern neurosurgery has allowed a broadening of resectability criteria by improving both extension and postoperative side effects. However, radical surgery is not always possible given the treatment site. This Special Issue would like to take stock of the impact of surgical treatment in clinical terms.

We hope to stimulate scientific attention on a delicate and highly impacting aspect in determining the clinical outcome of patients with brain and CNS neoplasms, such as surgical extension, which is a point that has still not been clarified in various oncological pathologies of the central nervous system. We believe it is necessary to develop a Special Issue to collect works focused on the impact and role of surgery in different oncological diseases in CNS. We look forward to your contributions.

Dr. Paolo Tini
Dr. Francesco Marampon
Dr. Giuseppe Minniti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • glioblastoma
  • low-grade gliomas
  • ependymomas
  • PNET
  • meningiomas
  • medulloblastomas
  • other brain tumors

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Published Papers (4 papers)

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Research

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13 pages, 1381 KiB  
Article
Improved Survival and Symptom Relief Following Palliative Cerebrospinal Fluid Diversion for Leptomeningeal Disease from Brain Cancers: A Case Series and Systematic Review
by Adela Wu, James Zhou and Stephen Skirboll
Cancers 2025, 17(2), 292; https://doi.org/10.3390/cancers17020292 - 17 Jan 2025
Viewed by 588
Abstract
Background: Leptomeningeal disease (LMD) from cancer indicates advanced cancer and can lead to obstructive hydrocephalus, for which palliative cerebrospinal fluid (CSF) diversion may be indicated to alleviate symptoms. We investigated surgical outcomes for hydrocephalus for adult patients with LMD and conducted a systematic [...] Read more.
Background: Leptomeningeal disease (LMD) from cancer indicates advanced cancer and can lead to obstructive hydrocephalus, for which palliative cerebrospinal fluid (CSF) diversion may be indicated to alleviate symptoms. We investigated surgical outcomes for hydrocephalus for adult patients with LMD and conducted a systematic review on pediatric and adult cases. Methods: We analyzed outcomes from a 10-year period of patients with neoplastic LMD, obstructive hydrocephalus, and documented date of death. We also searched databases from inception until 20 August 2022, using search terms including ‘cancer’, ‘hydrocephalus’, and ‘shunt’. Preferred reporting items for systematic reviews and meta-analyses guidelines were followed. Results: Among 50 patients, 30 (60%) underwent CSF diversion after LMD diagnosis with comparable median age in both the surgery (58.4 ± 14.4 years) and non-surgery (57.8 ± 14.5 years) groups. Twenty-three patients (76.7%) achieved symptom relief. The surgery group lived longer after LMD diagnosis than the non-surgery group (6.6 ± 6.0 vs. 1.3 ± 4.3 months, p < 0.001) and had a higher likelihood of survival (hazard ratio 2.49, 95% confidence interval 1.37–4.52, p = 0.002). Median survival after surgery was 2.8 ± 3.8 months. From 23 articles, 995 patients (34.3%) presented with LMD. Complication rates were 0–37.7% with no extraneural metastases. Symptom relief rates were 50–100%. Three studies reported median survival after surgery (2–3.3 months). Conclusions: A rare entity with dismal prognosis, LMD can present as symptomatic hydrocephalus in patients with cancer. Symptom relief and improved survival can be achieved with palliative CSF diversion with low complication rates. Prospective studies are needed to assess the outcomes and needs of these patients. Full article
(This article belongs to the Special Issue Impact of Surgery on Brain Cancer and Other Central Nervous System Tumors)
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Review

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22 pages, 679 KiB  
Review
Innovative Approaches to Brain Cancer: The Use of Magnetic Resonance-guided Focused Ultrasound in Glioma Therapy
by Aleksandra Ćwiklińska, Dominika Przewodowska, Dariusz Koziorowski and Stanisław Szlufik
Cancers 2024, 16(24), 4235; https://doi.org/10.3390/cancers16244235 - 19 Dec 2024
Viewed by 945
Abstract
Gliomas are a wide group of common brain tumors, with the most aggressive type being glioblastoma multiforme (GBM), with a 5-year survival rate of less than 5% and a median survival time of approximately 12–14 months. The standard treatment of GBM includes surgical [...] Read more.
Gliomas are a wide group of common brain tumors, with the most aggressive type being glioblastoma multiforme (GBM), with a 5-year survival rate of less than 5% and a median survival time of approximately 12–14 months. The standard treatment of GBM includes surgical excision, radiotherapy, and chemotherapy with temozolomide (TMZ). However, tumor recurrence and progression are common. Therefore, more effective treatment for GBM should be found. One of the main obstacles to the treatment of GBM and other gliomas is the blood–brain barrier (BBB), which impedes the penetration of antitumor chemotherapeutic agents into glioblastoma cells. Nowadays, one of the most promising novel methods for glioma treatment is Magnetic Resonance-guided Focused Ultrasound (MRgFUS). Low-intensity FUS causes the BBB to open transiently, which allows better drug delivery to the brain tissue. Under magnetic resonance guidance, ultrasound waves can be precisely directed to the tumor area to prevent side effects in healthy tissues. Through the open BBB, we can deliver targeted chemotherapeutics, anti-tumor agents, immunotherapy, and gene therapy directly to gliomas. Other strategies for MRgFUS include radiosensitization, sonodynamic therapy, histotripsy, and thermal ablation. FUS can also be used to monitor the treatment and progression of gliomas using blood-based liquid biopsy. All these methods are still under preclinical or clinical trials and are described in this review to summarize current knowledge and ongoing trials. Full article
(This article belongs to the Special Issue Impact of Surgery on Brain Cancer and Other Central Nervous System Tumors)
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19 pages, 3826 KiB  
Review
Interdisciplinary Therapeutic Approaches to Atypical and Malignant Meningiomas
by Leonidas Trakolis and Athanasios K. Petridis
Cancers 2023, 15(17), 4251; https://doi.org/10.3390/cancers15174251 - 25 Aug 2023
Cited by 2 | Viewed by 2266
Abstract
Meningiomas have the highest incidence among brain tumors. In contrast to benign tumors that constitute the majority of this tumor entity, the treatment of aggressive meningiomas (WHO Grade 2 and 3) is more challenging, requiring gross total removal of the tumor and the [...] Read more.
Meningiomas have the highest incidence among brain tumors. In contrast to benign tumors that constitute the majority of this tumor entity, the treatment of aggressive meningiomas (WHO Grade 2 and 3) is more challenging, requiring gross total removal of the tumor and the affected dura and adjuvant radiotherapy. Sometimes the location and/or the configuration of the tumor do not favor radical surgical resection without endangering the patient’s clinical condition after surgery and pharmacological therapy has, until now, not been proven to be a reliable alternative. Discussion: In this narrative review, we discuss the current literature with respect to the management of meningiomas, discussing the importance of the grade of resection in the overall prognosis of the patient and in the planning of adjuvant therapy. Conclusions: According to the location and size of the tumor, radical resection should be taken into consideration. In patients with aggressive meningiomas, adjuvant radiotherapy should be performed after surgery. In cases of skull base meningiomas, a maximal, though safe, resection should take place before adjuvant therapy. An interdisciplinary approach is beneficial for patients with primary or recurrent meningioma. Full article
(This article belongs to the Special Issue Impact of Surgery on Brain Cancer and Other Central Nervous System Tumors)
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Other

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11 pages, 823 KiB  
Perspective
Challenges and Opportunities in Accessing Surgery for Glioblastoma in Low–Middle Income Countries: A Narrative Review
by Paolo Tini, Giovanni Rubino, Pierpaolo Pastina, Salvatore Chibbaro, Alfonso Cerase, Francesco Marampon, Sergio Paolini, Vincenzo Esposito and Giuseppe Minniti
Cancers 2024, 16(16), 2870; https://doi.org/10.3390/cancers16162870 - 17 Aug 2024
Cited by 1 | Viewed by 1194
Abstract
Glioblastoma: a highly aggressive brain tumor, presents substantial challenges in treatment and management, with surgical intervention playing a pivotal role in improving patient outcomes. Disparities in access to brain tumor surgery arise from a multitude of factors, including socioeconomic status, geographical location, and [...] Read more.
Glioblastoma: a highly aggressive brain tumor, presents substantial challenges in treatment and management, with surgical intervention playing a pivotal role in improving patient outcomes. Disparities in access to brain tumor surgery arise from a multitude of factors, including socioeconomic status, geographical location, and healthcare resource allocation. Low- and middle-income countries (LMICs) often face significant barriers to accessing surgical services, such as shortages of specialized neurosurgical expertise, limited healthcare infrastructure, and financial constraints. Consequently, glioblastoma patients in LMICs experience delays in diagnosis, suboptimal treatment, and poorer clinical outcomes compared to patients in high-income countries (HICs). The clinical impact of these disparities is profound. Patients in LMICs are more likely to be diagnosed at advanced disease stages, receive less effective treatment, and have lower survival rates than their counterparts in HICs. Additionally, disparities in access to surgical care exacerbate economic and societal burdens, emphasizing the urgent need for targeted interventions and health policy reforms to address healthcare inequities. This review highlights the importance of addressing global disparities in access to brain tumor surgery for glioblastoma through collaborative efforts, policy advocacy, and resource allocation, aiming to improve outcomes and promote equity in surgical care delivery for all glioblastoma patients worldwide. Full article
(This article belongs to the Special Issue Impact of Surgery on Brain Cancer and Other Central Nervous System Tumors)
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