Glioma Supra Marginal Incision Trial

G-SUMIT is a pilot, phase II,randomized controlled trial to evaluate the feasibility of performing a large-scale trial in patients undergoing surgery for first-time diagnosis of high grade glioma (HGG) in a surgically favorable anatomical location to answer the following: Does extending the margin of resection 1 cm beyond visible enhanced volume on MRI result in (a) an increase in overall survival? (b) result in a similar rate of "clinically-significant" neurological worsening during 30 days post surgery and quality of life at 6 and 12 months?

Inclusion Criteria: 1. Radiographic evidence of a GAD-enhancing intra-axial tumor consistent with HGG; 2. Age ≥18 ≤ 85 years; 3. Karnofsky Performance Score ≥ 60; 4. Location of tumor in a safe anatomical location and 5. Patient or substitute decision maker (SDM) able to understand and consent to study participation. Exclusion Criteria: 1. Multi-focal tumor, gliomatosis cerebri (≥3 lobes of the brain affected), tumors crossing the midline, or leptomeningeal enhancement; 2. Previous craniotomy for tumor excision (stereotactic biopsy is permitted); 3. Known metastatic cancer; 4. Uncorrectable coagulopathy; 5. Unable to obtain GAD-enhanced brain MRI.