P.137 Surgical approaches to adult thalamic gliomas: a systematic review

Abstract

Background: Adult thalamic gliomas (ATGs) present a surgical challenge given their depth and proximity to eloquent brain regions.Though a relative abundance of literature has been published regarding the surgical management of thalamic lesions in pediatric patients, a scarce amount exists dedicated to adult populations. Methods: Literature regarding surgical management of thalamic gliomas in adult patients was reviewed according to the PRISMA guidelines. Fours databases were searched with keywords “‘thalamic glioma’ AND ‘surgical intervention’ OR ‘thalamic glioma’ AND ‘surgical treatment’” in July 2021 for articles assessing surgical techniques of ATG resection. Results: The mean age of adult undergoing surgical management was 33.57 years with a median preoperative KPS of 72.15. Among the 507 cases, several surgical approaches were utilized. Transcortical approaches were most frequently used accounting for 37.8% of all cases followed by transventricular (23.8%), transcallosal (22.8%), and trans-sylvian transinsular (2.92%). Conclusions: Studies in this review agree that decreased age, low grade glioma, increased KPS, and increased duration of symptoms are positive prognostic factors. Greater degree of resection provides a positive survival benefit, and transcortical approaches appear to carry a greater overall survival. Stratified guidelines could pose an overall advantage to surgical success when making decisions on treatment approach.