{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:14:15Z","timestamp":1787656455591,"version":"build-2736575974"},"reference-count":41,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>The present review aims to investigate the survival and functional outcomes in adult high-grade brainstem gliomas (BGSs) by comparing data from resective surgery and biopsy. MEDLINE, EMBASE and Cochrane Library were screened to conduct a systematic review of the literature, according to the PRISMA statement. Analysis was limited to articles including patients older than 18 years of age and those published from 1990 to September 2022. Case reports, review articles, meta-analyses, abstracts, reports of aggregated data, and reports on multimodal therapy where surgery was not the primary treatment were excluded. The ROBINS-I tool was applied to evaluate the risk of bias. Six studies were ultimately considered for the meta-analysis. The resective group was composed of 213 subjects and the bioptic group comprised 125. The analysis demonstrated a survival benefit in those patients in which an extensive resection was possible (STR HR 0.59 (95% CI 0.42, 0.82)) (GTR HR 0.63 (95% CI 0.43, 0.92)). Although surgical resection is associated with increased survival, the significantly higher complication rate makes it difficult to recommend surgery instead of biopsy for BSGs. Future investigations combining volumetric data and molecular profiles could add important data to better define the proper indication between resection and biopsy.<\/jats:p>","DOI":"10.3390\/curroncol30110709","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:44:18Z","timestamp":1699317858000},"page":"9772-9785","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Surgical Management of Adult Brainstem Gliomas: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3741-0639","authenticated-orcid":false,"given":"Tamara","family":"Ius","sequence":"first","affiliation":[{"name":"Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1316-2132","authenticated-orcid":false,"given":"Giuseppe","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Oncology 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Baiano","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Universit\u00e0 degli Studi di Napoli Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Berardinelli","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Universit\u00e0 degli Studi di Napoli Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Romano","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, NESMOS S.Andrea Hospital, University Sapienza, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3686-8907","authenticated-orcid":false,"given":"Nicola","family":"Montemurro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, 56123 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi Maria","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Universit\u00e0 degli Studi di Napoli Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0788-1205","authenticated-orcid":false,"given":"Francesco","family":"Pasqualetti","sequence":"additional","affiliation":[{"name":"Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Feletti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, 37129 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"ref_1","unstructured":"Choux, M. 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