Philipp Karschnia: The oncological role of surgery in diffuse gliomas

Philipp Karschnia, Neurosurgery resident at  Ludwig-Maximilians-University of Munich, shared on X:

“RANO review on the oncological role of surgery in diffuse gliomas published in The Lancet Oncology – and excitingly featured on the cover page.

The oncological role of resection in newly diagnosed diffuse adult-type glioma defined by the WHO 2021 classification: a Review by the RANO resect group

Authors: 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, Arnaud J. P. E. Vincent, Michelle M. Kim, Guido Reifenberger, Susan M. Chang, Shawn L. Hervey-Jumper, Mitchel S. Berger, Joerg-Christian Tonn.

Evidence that surgery matters for glioma patients in the era of the WHO 2021 classification

• accumulating evidence that not only CE but also non-CE tumor portion prognostically matters in IDHwt glioblastoma
• what matters is what has been left behind (i.e. absolute residual tumor) not what has been taken out (i.e. relative tumor reduction)

In IDHmut astrocytomas, strong evidence that life years can be saved when more extensive resection is provided: resection beyond visible tumor margins as a novel surgical approach might be worth ‘taking a risk’ to leave no tumor behind (in a shared decision-making process).

In 1p19q-codel oligodendrogliomas, wider resections associated with improved outcome but overall more benign tumor nature and well-working medical/radiotherapeutic approaches call for a somewhat less aggressive surgical approach.

Great team effort from our RANO resect group including surgeons Nico Teske, Asgeir Jakola, Shawn Hervey-Jumper, radiation oncologistsMichelle Kim, and medical neuro-oncologists Martin van den Bent (and lot of amazing twitterless colleagues).”

Source: Philipp Karschnia/X