A Systematic Review of Comparison of Early Surgical Intervention versus Followup in Management of Adult-Type Diffuse Low Grade Gliomas with No Motor Neurological Deficit in Terms of Survival Rate and Quality of Life: A Systematic Review

Abstract Background The precise optimal management of patients with low-grade glioma remains to be determined. Active surveillance, needle or open biopsy, as well as surgical resection have all been advocated by different authors. Surgical resection is superior when compared with observation to improve overall survival for patients with LGG (Level III) although observation has no negative impact on cognitive performance and quality of life (Level II). Objective To systematically review the available literature discussing the outcome of early resection versus followup on overall survival and quality of life of such patients. With evaluation of the impact of extent of resection on overall survival and the value of utilizing preoperative and intraoperative technical aids (imaging and mapping) on the postoperative functional outcome. Patients and Methods Systematic review of published English literature from Jan. 2000 to Jan. 2024. Results A total of 10955 citations were retrieved according to our search strategy and review of bibliographies. 10 of these studies met the inclusion criteria and were included in the analysis, 7 were before 2021, 3 were after 2021. They were obtained from Medline via PubMed. Conclusion DLGGs management is multimodal and involving the interplay of the treatment modalities. The determination of an optimal treatment plan for a DLGGs patient should be individualized based on the patient’s age, sex, location of tumor, molecular status, and co- morbidities. Besides, putting into consideration the timing (early vs. delayed) of treatment as well as the positive and negative impacts of treatment on survival, quality of life, and seizures control. However, it’s clear that the introduction of the new technical aids, has improved all the outcomes of the surgical resection, rendering it the superior option of the two at the current time.