Multimodal Strategies in the Surgical Management of Brain Tumors: Innovations, Outcomes, and Future Directions

Brain tumors represent a significant challenge in neurosurgery due to their complex location, heterogeneity, and impact on neurological function. Despite advances in oncological therapies, surgical resection remains a cornerstone in the treatment of both primary and metastatic brain tumors. Over the past decade, neurosurgical oncology has experienced rapid technological growth, including the integration of intraoperative MRI, fluorescence-guided surgery, neuronavigation, and awake craniotomy techniques.
These innovations aim to maximize tumor removal while preserving neurological function. Simultaneously, the understanding of tumor biology and its radiological correlates has led to more personalized surgical approaches. However, translating these innovations into improved survival and quality of life remains a challenge, warranting a dedicated focus on outcome-driven research.
This Research Topic aims to explore the current challenges and opportunities in the surgical management of brain tumors. This Research Topic will encompass both primary and metastatic brain tumors, with a focus on their surgical management across diverse patient populations. We particularly encourage studies addressing challenges and innovations in treating brain tumors in both adult and pediatric patients, given the differing biological behaviours and surgical considerations. Although novel intraoperative technologies and preoperative planning tools have enhanced the neurosurgeon's ability to achieve safer and more complete resections, their impact on long-term oncological outcomes and patient-centred endpoints is still being evaluated. Moreover, the variability in surgical approaches across institutions raises questions about standardization, accessibility, and training in neuro-oncological techniques. The integration of molecular diagnostics, radiomics, and artificial intelligence into surgical decision-making is another emerging frontier that promises to redefine precision surgery. In this Research Topic, we also aim to collect original research, systematic reviews, and expert perspectives that evaluate current innovations, identify unmet clinical needs, and propose solutions to optimize surgical care for patients with brain tumors.
We welcome contributions that address innovative surgical techniques, intraoperative technologies, and outcome assessments in the treatment of brain tumors. Topics may include, but are not limited to, fluorescence-guided surgery, intraoperative imaging, awake
surgery, radiogenomics, integration of artificial intelligence, and analysis of surgical morbidity and quality of life. Submissions focusing on both adult and pediatric populations are encouraged. Manuscripts can be original research articles, systematic reviews, mini-reviews, brief research reports, clinical trials, or opinion pieces. Case Reports are excluded. Multidisciplinary collaborations between neurosurgeons, neurooncologists, radiologists, and basic scientists are particularly welcome. The goal is to provide a comprehensive and translational overview of how surgical innovation can improve neuro-oncological outcomes.
Please note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal.