Supratotal Resection Yields Better Seizure Outcomes in Low-Grade Glioma Surgery

Strategic Insights -

Patients with low-grade gliomas (LGG) who undergo supratotal resection (SpTR) through a combination of intraoperative Electrocorticography (iECoG) and navigated Transcranial Magnetic Stimulation (nTMS) experience significantly better seizure outcomes compared to those who undergo gross total resection (GTR) alone. According to a new study published in Acta Neurochirurgica, SpTR is more frequently achievable than radiologically defined SpTR, and yields better seizure outcomes without compromising functional outcomes compared to GTR.

Key Takeaways:

  • The study, which included 30 patients, found that 86.6% of those who underwent SpTR achieved seizure freedom, compared to only 20% of those who underwent GTR.
  • The rate of postoperative neurological deficits was the same for both groups, indicating that SpTR does not compromise functional outcomes.
  • The study used iECoG to identify LGG-related epileptogenic foci and nTMS to predict postoperative deficits, demonstrating the effectiveness of these techniques in achieving better seizure outcomes.
  • Supratotal resection is more frequently achievable than traditionally defined supratotal resection, with 13.3% of patients in the study achieving margins of 1 cm or less.
  • The study suggests that iECoG is a reliable technique for identifying LGG-related epileptogenic foci, and nTMS is a trustworthy method for predicting postoperative deficits.

Statistics:

  • 86.6% of patients who underwent SpTR achieved seizure freedom, compared to 20% of those who underwent GTR.
  • 13.3% of patients in the study achieved resection margins of 1 cm or less.
  • 30 patients were included in the study, divided into groups I (GTR) and II (iECoG nTMS Tailored - SpTR).
  • The study had a minimum follow-up period of 12 months.

Sources:

  • NewsRx. Researchers at University of Florence Target Magnetic Field Therapy [Epileptogenic LGG surgery with seizure freedom purpose: Supratotal resection (ETT-SpTR) based on Electrocorticography and navigated transcranial magnetic stimulation]. Health & Medicine Week. October 24, 2025; p 1787.
  • "Epileptogenic LGG surgery with seizure freedom purpose: Supratotal resection (ETT-SpTR) based on Electrocorticography and navigated transcranial magnetic stimulation." Acta Neurochirurgica, 2025;167(1):268.
  • Springer Wien, Prinz-Eugen-Strasse 8-10, A-1040 Vienna, Austria.