Neurosurgeons still wanted

It is tempting to speculate that advances in molecularly targeted therapy might diminish the important role that surgeons have always played in the care of patients with glioblastoma (GBM). Maximum safe resection of at least the contrast-enhancing portion of the tumor mass is the desired starting point for treatment regimens in modern neuro-oncology. Surgical excision of >70% of the enhancing tumor volume significantly prolongs the overall survival of patients with GBM who are treated with the proven combination of external-beam radiation and temozolomide chemotherapy after initial diagnosis.^1–3 We do not know, however, whether the survival advantage associated with surgery observed in the radiation–temozolomide era of neuro-oncology will carry over into the future as highly selective anticancer drugs and immunotherapy agents emerge from the development pipeline and enter the clinic. The results of the study published by Ellingson and colleagues indicate that neurosurgeons will likely remain an effective strike force in the war on GBM even as medical treatment methods improve.⁴