• Philipp Karschnia, Jasper K W Gerritsen, Nico Teske, Daniel P Cahill, Asgeir S Jakola, Martin van den Bent, Michael Weller, Oliver Schnell, Einar O Vik-Mo, Niklas Thon, VincentArnaud J P EAJPEDepartment of Neurosurgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands., Michelle M Kim, Guido Reifenberger, Susan M Chang, Shawn L Hervey-Jumper, Mitchel S Berger, and Joerg-Christian Tonn.
• Department of Neurosurgery, Ludwig-Maximilians-University, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Germany.
• Lancet Oncol. 2024 Sep 1; 25 (9): e404e419e404-e419.

AbstractGlioma resection is associated with prolonged survival, but neuro-oncological trials have frequently refrained from quantifying the extent of resection. The Response Assessment in Neuro-Oncology (RANO) resect group is an international, multidisciplinary group that aims to standardise research practice by delineating the oncological role of surgery in diffuse adult-type gliomas as defined per WHO 2021 classification. Favourable survival effects of more extensive resection unfold over months to decades depending on the molecular tumour profile. In tumours with a more aggressive natural history, supramaximal resection might correlate with additional survival benefit. Weighing the expected survival benefits of resection as dictated by molecular tumour profiles against clinical factors, including the introduction of neurological deficits, we propose an algorithm to estimate the oncological effects of surgery for newly diagnosed gliomas. The algorithm serves to select patients who might benefit most from extensive resection and to emphasise the relevance of quantifying the extent of resection in clinical trials.Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.

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