Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Yawkey 9E, Boston, MA 02114, USA.
Neurosurg Clin N Am. 2021 Jan;32(1):23-29. doi: 10.1016/j.nec.2020.09.006. Epub 2020 Nov 5.
The work of modern neurosurgical glioma practice combines securing accurate diagnoses, under the 2016 revised World Health Organization (WHO) Classification of Tumors of the Central Nervous System, with an aggressive and safe surgical pursuit of tumor removal. The evidence base that drives clinical decision-making has undergone a critical reevaluation with the incorporation of molecular classifiers into the updated WHO diagnoses including the 3 most common diffuse gliomas in adults: glioblastoma IDH wild-type, astrocytoma IDH mutant, and oligodendroglioma IDH mutant 1p/19q codeleted. The studies that form the foundation of modern practice, and the areas for future inquiry are reviewed.
现代神经外科脑肿瘤实践的工作结合了在 2016 年修订的《世界卫生组织中枢神经系统肿瘤分类》下进行准确诊断,以及积极和安全地进行肿瘤切除的追求。推动临床决策的证据基础随着分子分类器纳入更新的世界卫生组织诊断而经历了关键的重新评估,包括成人中最常见的 3 种弥漫性神经胶质瘤:异柠檬酸脱氢酶野生型胶质母细胞瘤、异柠檬酸脱氢酶突变型星形细胞瘤和 1p/19q 联合缺失的少突胶质细胞瘤 IDH 突变型。本文回顾了形成现代实践基础的研究以及未来研究的领域。