There is a lack of class I evidence concerning the impact of surgery in the treatment of diffuse low-grade glioma; the early maximal resection with preservation of eloquent brain areas has been accepted as the first therapeutic option. We performed a systematic review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and protocol. Inclusion criteria: only case series with at least 100 patients containing supratentorial hemispheric diffuse low-grade glioma (according to any of the WHO classification used in papers published between 2000 to 2019), with pre- and postoperative MRI study were included in the qualitative and quantitative analyses. The extent of resection should be defined based on MRI at least in two categories and correlated with patients’ outcomes (with univariate or multivariate analyses) using overall survival (OS) or malignant progression-free survival (MPFS). A total of 18 series with 4386 patients, published in 20 papers, were included in this systematic review. All the series that evaluates the relation between the extent of resection (EOR) and OS showed a statistically significant improvement of OS at univariate and/or multivariate analyzes with a greater EOR. Six studies showed a statistically significant improvement of MPFS with a greater EOR. We demonstrate that when a more rigorous analysis of EOR is performed, a benefit of a more aggressive resection on OS and MPFS is observed. Our review about EOR in different molecular groups of DLGG also suggests a benefit of maximum safe resection for all different subtypes, even though “radical surgery” may be associated with better OS and MPFS in tumors with a more aggressive signature.

缺乏关于手术对弥漫性低度神经胶质瘤治疗的影响的I类证据。早期的最大切除术并保留了有力的大脑区域已被接受为第一种治疗选择。我们使用系统评价和荟萃分析的首选报告项目（PRISMA）指南和协议对文献进行了系统的综述。纳入标准：定性和定量分析仅包括病例组，该病例组至少有100名患者患有幕上半球弥漫性低度神经胶质瘤（根据2000年至2019年发表的论文中使用的WHO分类标准），并进行了术前和术后MRI研究。定量分析。切除范围应至少根据MRI分为两类，并使用总体生存期（OS）或恶性无进展生存期（MPFS）与患者的预后相关（单因素或多因素分析）。该系统评价共纳入18篇系列文章，共4386名患者，共20篇论文。所有评估切除范围（EOR）与OS之间关系的系列均显示，单变量和/或多变量分析中EOS更高时，OS在统计学上有显着改善。六项研究表明，统计学意义上的MPFS改善具有更大的EOR。我们证明，当对EOR进行更严格的分析时，可以观察到OS和MPFS切除更为积极的好处。