Editing Brain tumor (section)

===Surgery===
Surgical resection of the greatest extent of contrast enhancing tumor possible (gross total resection) is associated with increased overall and progression free survival in those with glioblastoma. Gross total resection is often required in other brain tumors.<ref name="Schaff 2023" /> Minimally invasive techniques are becoming the dominant trend in neurosurgical oncology.<ref>{{cite journal | vauthors = Spetzler RF, Sanai N | title = The quiet revolution: retractorless surgery for complex vascular and skull base lesions | journal = Journal of Neurosurgery | volume = 116 | issue = 2 | pages = 291–300 | date = February 2012 | pmid = 21981642 | doi = 10.3171/2011.8.JNS101896 | doi-access = free }}</ref> The main objective of surgery is to remove as many tumor cells as possible, with complete removal being the best outcome and [[cytoreduction]] ("debulking") of the tumor may otherwise be done. Due to the infiltrative nature of glioblastomas, total resection is usually unachievable and progression after surgery usually occurs, with progression occurring about 7 months after surgery.<ref name="Schaff 2023" />

Many [[meningiomas]], with the exception of some tumors located at the skull base, can be successfully removed surgically.
Most [[pituitary adenoma]]s can be removed surgically, often using a minimally invasive approach through the [[nasal cavity]] and skull base (trans-nasal, trans-sphenoidal approach). Large [[pituitary adenoma]]s require a [[craniotomy]] (opening of the skull) for their removal. Radiotherapy, including [[stereotactic]] approaches, is reserved for inoperable cases.<ref>{{cite journal | vauthors = Gheorghiu ML, Fleseriu M | title = Stereotactic Radiation Therapy in Pituitary Adenomas, is it Better than Conventional Radiation Therapy? | journal = Acta Endocrinologica | volume = 13 | issue = 4 | pages = 476–490 | date = 2017 | pmid = 31149219 | pmc = 6516550 | doi = 10.4183/aeb.2017.476 }}</ref>

Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors.<ref>{{cite journal |last1=Penoncello |first1=Gregory P. |last2=Gagneur |first2=Justin D. |last3=Vora |first3=Sujay A. |last4=Yu |first4=Nathan Y. |last5=Fatyga |first5=Mirek |last6=Mrugala |first6=Maciej M. |last7=Bendok |first7=Bernard R. |last8=Rong |first8=Yi |title=Comprehensive Commissioning and Clinical Implementation of GammaTiles STaRT for Intracranial Brain Cancer |journal=Advances in Radiation Oncology |date=July 2022 |volume=7 |issue=4 |pages=100910 |doi=10.1016/j.adro.2022.100910 |pmid=35434425 |pmc=9010698 |s2cid=246623373 }}</ref><ref name="pmid11150363">{{cite journal | vauthors = DeAngelis LM | title = Brain tumors | journal = The New England Journal of Medicine | volume = 344 | issue = 2 | pages = 114–23 | date = January 2001 | pmid = 11150363 | doi = 10.1056/NEJM200101113440207 | issn = 0028-4793}}</ref>

Multiple metastatic tumors are generally treated with radiotherapy and chemotherapy rather than surgery and the prognosis in such cases is determined by the primary tumor, and is generally poor.{{Citation needed|date=October 2024}}