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Book and Media Review
September 2014

Review of Controversies in Neuro-Oncology: Best Evidence Medicine for Brain Tumor Surgery

Author Affiliations
  • 1Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston
JAMA Neurol. 2014;71(9):1195. doi:10.1001/jamaneurol.2014.1823

Primary central nervous system tumors occur at alarmingly high rates: 21 cases per 100 000 people each year in the United States1 (compared with multiple sclerosis, with a worldwide annual incidence of 5.6 cases per 100 000,2 and amyotrophic lateral sclerosis, with an annual incidence of 1.2-2.2 cases per 100 000 in the western hemisphere36). Thankfully, the most common among these primary central nervous system tumors are meningiomas,1 which are generally benign but may nonetheless require surgery for pathologic diagnosis or to reduce neurologic symptoms from local mass effect. For malignant tumors of the central nervous system, glioblastoma being the most common and most pathologically aggressive example, surgery is not only important for these reasons, but the extent of surgical resection is positively correlated with overall survival.7 Given this information, it is no surprise that neurosurgery is essential to the multidisciplinary neuro-oncology practice. As such, a neurologist’s or neuro-oncologist’s knowledge of the best evidence for brain tumor surgery will benefit their professional discussions, research, and ultimately patient care.

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