Reoperation in recurrent high-grade gliomas: literature review of prognostic factors and outcome.

Two percent of cancer deaths are caused by malignant primary brain tumors, and most of these are high-grade gliomas. Despite the treatment given, malignant gliomas recur early. Mean survival is less than 12 months, and only 20% of patients survive for more than 2 years. This rapid course induces some physicians to resort to all the therapeutic options available and, at recurrence, to reevaluate the patient for a second intervention. Others consider reoperation to be an overtreatment. The debate is ongoing, and an answer likely will be found only through better identification of the prognostic factors that will identify patients who will benefit from reoperation.