Gliomes de haut grade du sujet âgé : place de la chirurgie

High-grade glioma is the second most frequent primary intracranial tumour in the elderly. Their optimal management includes gross total resection, radiation therapy and chemotherapy. However, some preoperative factors seem to be of bad prognosis for nonbiopsy resection: functional status, tumour size and location, but also associated pathologies such as chronic obstructive pulmonary disease. Biopsy seems to be an appropriate alternative for deep, unoperable lesions and frail patients. Any surgery (biopsy or aggressive surgery) cannot be conceivable without secondary therapeutic treatment.