Surgical resection and prognostic analysis for gliomas in the left ventral precentral gyrus

Hao Xiaotao; Ma Nainai; Zhou Yuyao; Lu Junfeng

doi:10.11850/j.issn.1009-122X.2025.01.008

Abstract：Objective To explore the surgical resection strategy of the left ventral precentral gyrus(vPrCG)glioma,and to evaluate the survival prognosis and language function of patients after resection of the left vPrCG gliomas.Methods The clinical data of 19 patients with left vPrCG gliomas were analyzed retrospectively.Preoperatively,multimodal imaging navigation fusion and reconstruction techniques were used for surgical planning.Intraoperatively,awake anesthesia combined with language cortex and subcortical localization techniques were used to locate and protect the language function area,and the tumor was safely resected to the maximum extent with the assistance of navigation and intraoperative magnetic resonance imaging.Postoperatively,the patients were followed up regularly for language function prognosis and survival prognosis.Results Among the 19 patients,10(52.6%)had preoperative aphasia,17(89.5%)had aphasia 1 month after surgery,12(63.2%)had aphasia 3 months after surgery,and 2(10.5%)patients had new long-term aphasia.The scores of the four language sub-scores of self-speech,repetition,comprehension and naming all decreased significantly at 1 month after operation,and showed a certain degree of recovery at 3 months after surgery,but the recovery of self-speech and naming function was relatively poor.There was no significant difference in the prognosis of language function between patients with low-grade glioma(LGG)and high-grade glioma(HGG).The average degree of tumor resection in 19 patients was 89.7%,and 14 patients(73.7%)achieved complete or near-total resection(resection extent≥90%).In the LGG group(10 cases),the average degree of tumor resection was 85.6%,the follow-up time was 14-114 months,and the median progression-free survival(PFS)and median overall survival(OS)were 77 months and not reached,respectively.The average degree of tumor resection in the HGG group(9 cases)was 94.4%,the follow-up time was 13-88 months,and the median PFS and median OS were 18 months and 47 months,respectively.Conclusions For the relatively surgically forbidden area of the left vPrCG,with the assistance of multimodal imaging navigation,the use of awake anesthesia combined with language function area localization and protection techniques enables the achievement of maximum safe resection,thereby achieving a balance between functional prognosis and survival prognosis.