10115-STMO-4 SURGICAL OUTCOMES OF AWAKE SURGERY FOR GLIOBLASTOMA

Abstract OBJECTIVE Awake surgery contributes to maximal resection of brain tumors and preservation of brain function. In this study, we investigated the surgical outcomes, efficacy and safety of awake surgery for glioblastoma (GBM) at our institution. METHOD All GBM patients who underwent awake surgery at our institution from March 2010 to February 2023 were included. We retrospectively analyzed the clinical characteristics, response to awake mapping, extent of resection, and postoperative complications. RESULTS Seventy-five patients, 92 surgeries were included in the study. Median age at surgery was 47 years, 51 cases (55.4%) were males, and 41 cases (44.6%) were females. Thirty-one cases (33.7%) were primary diseases, 59 cases (64.1%) were recurrent, and 2 cases (2.2%) were residual diseases. Positive responses for awake mapping were observed in 49 cases (53.3%). The resections were discontinued in 38 cases (41.3%) based on the mapping findings. Gross total resection was achieved in 48 cases (52.2%), subtotal resection in 26 cases (28.3%), partial resection in 14 cases (15.2%), and biopsy in 4 cases (4.2%). Twenty-two cases (23.9%) showed neurological deterioration in the acute postoperative period, whereas 5 cases (5.4%) showed deficit 3 months after surgery. Among patients whose excision was discontinued based on mapping findings, one case (1.1%) developed right hemiparesis due to late-onset cerebral infarction, whereas no neurological deficits were observed in the other cases 3 months after surgery. CONCLUSION Complications of awake surgery for glioblastoma were rare. Half of the cases showed positive response to awake mapping. Awake mapping is necessary to resect glioblastoma located in eloquent areas while preserving brain function.