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.

IF 41.6 1区 医学 Q1 ONCOLOGY Lancet Oncology Pub Date : 2024-09-01 DOI:10.1016/S1470-2045(24)00130-X
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
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Abstract

Glioma 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.

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根据世卫组织 2021 年分类法定义的新诊断弥漫成人型胶质瘤切除术的肿瘤学作用:RANO resect 小组综述。
胶质瘤切除术与生存期延长有关,但神经肿瘤学试验往往不对切除范围进行量化。神经肿瘤学反应评估(RANO)切除小组是一个国际性的多学科小组,旨在通过界定手术在世界卫生组织 2021 年分类中定义的弥漫成人型胶质瘤中的肿瘤作用来规范研究实践。根据肿瘤分子特征的不同,大面积切除的有利生存效果可持续数月至数十年。对于侵袭性更强的肿瘤,最大限度的切除可能会带来额外的生存获益。在权衡肿瘤分子特征与临床因素(包括神经功能缺损的出现)所决定的切除术预期生存益处后,我们提出了一种算法,用于估算新诊断胶质瘤手术的肿瘤学效应。该算法用于选择可能从广泛切除术中获益最多的患者,并强调在临床试验中量化切除范围的意义。
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来源期刊
Lancet Oncology
Lancet Oncology 医学-肿瘤学
CiteScore
62.10
自引率
1.00%
发文量
913
审稿时长
3-8 weeks
期刊介绍: The Lancet Oncology is a trusted international journal that addresses various topics in clinical practice, health policy, and global oncology. It covers a wide range of cancer types, including breast, endocrine system, gastrointestinal, genitourinary, gynaecological, haematological, head and neck, neurooncology, paediatric, thoracic, sarcoma, and skin cancers. Additionally, it includes articles on epidemiology, cancer prevention and control, supportive care, imaging, and health-care systems. The journal has an Impact Factor of 51.1, making it the leading clinical oncology research journal worldwide. It publishes different types of articles, such as Articles, Reviews, Policy Reviews, Personal Views, Clinical Pictures, Comments, Correspondence, News, and Perspectives. The Lancet Oncology also collaborates with societies, governments, NGOs, and academic centers to publish Series and Commissions that aim to drive positive changes in clinical practice and health policy in areas of global oncology that require attention.
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