The management of brain tumours, particularly diffuse gliomas (WHO grades 2–4), remains one of the most complex challenges in modern neurosurgery. This Research Topic welcomes submissions addressing both adult and paediatric brain tumours, as well as primary and secondary brain tumours, including brain metastases from extracranial solid or haematological malignancies. Their infiltrative growth patterns and frequent proximity to eloquent brain regions often limit the extent of safe resection. While maximal tumour resection, defined radiologically, has consistently been associated with improved outcomes, the benefit of incomplete resection remains uncertain, highlighting the need for careful, individualised surgical decision-making. In many cases, stereotactic biopsy may represent a more appropriate approach when the risks of surgery outweigh potential oncological gains.
Personalised surgical care in neuro-oncology requires the integration of multiple patient- and tumour-specific factors, including age, functional status, tumour grade, size, anatomical location, and radiographic characteristics. Increasingly, molecular profiling has transformed our understanding of tumour biology and prognosis, further refining treatment strategies. For instance, specific molecular subtypes may derive greater benefit from adjuvant therapies, thereby influencing the role and extent of surgical intervention. As such, surgical planning is no longer guided solely by anatomical considerations but must also account for tumour biology and anticipated response to multimodal treatment.
A central tenet of contemporary neuro-oncological surgery is the preservation of neurological function. In eloquent brain regions, the principle of “do no harm” remains paramount, particularly given the absence of level 1 evidence supporting aggressive resection in all contexts. Surgery-related morbidity may delay adjuvant therapies such as radiotherapy or chemotherapy, potentially compromising overall outcomes. Therefore, the balance between oncological control and functional preservation is critical and must be tailored to each individual patient.
Beyond surgical decision-making, the broader management of brain tumour patients necessitates a holistic and multidisciplinary approach. Patients frequently experience a wide spectrum of symptoms, including seizures, cognitive impairment, fatigue, mood disturbances, and thromboembolic complications, all of which significantly impact quality of life. Optimising medical management alongside surgical and oncological treatments is essential to improving both survival and functional outcomes.
Equally important is the role of shared decision-making in neuro-oncology. Given the complexity of treatment options and the potential trade-offs between survival and quality of life, patient values and preferences must be central to the decision-making process. Personalised care extends beyond biological and clinical factors to include meaningful patient engagement, ensuring that treatment strategies align with individual goals and expectations. This article collection aims to explore the evolving landscape of personalised surgical care in neuro-oncology.
We welcome contributions addressing surgical strategy, advanced imaging, intraoperative technologies, molecular-guided decision-making, multidisciplinary care models, outcome assessment, and patient-centred approaches across adult and paediatric neuro-oncology, and in the context of both primary brain tumours and secondary brain tumours/brain metastases where relevant. By integrating innovation with individualised care, this collection seeks to advance the precision and quality of neuro-oncological practice.
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
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Article types
This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:
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