Extent of Resection Versus Molecular Classification: What Matters When?

For malignant gliomas, the survival benefit of new combination therapies after surgical resection is measured in weeks to months. In contrast, optimizing treatment for low-grade gliomas can potentially provide additional years of life. The relatively indolent but not benign clinical course provides the opportunity for clinicians and scientists to focus not only on the duration of survival, but also to maximize quality of life. Ideal management of low-grade gliomas among the most important yet paradoxically most neglected subjects in neuro-oncology. This article examines the molecular underpinnings of these tumors and evaluates the role of extensive surgery in maximizing outcomes.