• Kelly Jiang, Anita Kalluri, Michelle Odonkor, Daniel Martinez Heinemann, Carly Weber-Levine, Divyaansh Raj, Joshua Materi, Maureen Rakovec, Estela Pineda, Kristin J Redmond, Carlos Romo, David O Kamson, Matthias Holdhoff, Karisa C Schreck, José Juan González Sánchez, Chetan Bettegowda, and Jordina Rincon-Torroella.
• Department of Neurosurgery, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287.
• World Neurosurg. 2025 Feb 11: 123716123716.

ObjectiveOligodendrogliomas present challenges in management despite their favorable prognosis. Optimal therapeutic strategies are not well-established. We aimed to characterize current practice patterns and identify areas of discordance in oligodendroglioma management.MethodsA 20-question survey was distributed February-July 2023 to four professional neurosurgery/neuro-oncology societies to assess practices in oligodendroglioma management. The survey collected data on demographics, diagnostic practices, and treatment decisions. Data analysis was performed using chi-square/Fisher's exact tests.ResultsSixty-three physicians responded, representing 12 countries. Diagnostic practices were consistent among respondents. However, variations in management recommendations were observed. Providers were divided between rarely (36.5%), sometimes (25.4%), and often (30.2%) using TMZ as sole chemotherapy for patients with newly diagnosed oligodendroglioma. For patients with subtotal resection of grade 2 oligodendroglioma, 33.3% of providers recommended upfront radiation/chemotherapy, 27.0% recommended observation, and the remaining 39.7% were divided among options including surgery, chemotherapy, and clinical trials. European providers more frequently recommended surgery (33.3% vs 0.0%), whereas radiation/chemotherapy (35.7% vs 26.7%) or observation (31.0% vs 13.3%) were more commonly recommended by US/Canada providers (p=0.009). Providers also disagreed on adjuvant therapy for grade 3 oligodendroglioma. 47.6% recommended radiation/PCV, and 33.3% recommended radiation/TMZ. This decision varied by region, with European providers more frequently recommending radiation/PCV (86.7% vs 33.3%), and US/Canadian providers more frequently recommending radiation/TMZ (40.5% vs 6.7%; p=0.004).ConclusionThis study underscores the complexity of oligodendroglioma management and the importance of ongoing research to refine therapeutic strategies. Further studies, especially with the introduction of IDH inhibitors in the practice, are warranted to track practice patterns and reassess recommendations.Copyright © 2025. Published by Elsevier Inc.

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