Department of Neurosurgery, Ludwig-Maximilians-University, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Germany.
Department of Neurosurgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands; Department of Neurosurgery and Division of Neuro-Oncology, University of San Francisco, San Francisco, CA, USA.
Lancet Oncol. 2024 Sep;25(9):e404-e419. doi: 10.1016/S1470-2045(24)00130-X.
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.
胶质瘤切除术与生存时间延长相关，但神经肿瘤学试验常常避免量化切除范围。反应评估在神经肿瘤学（RANO）切除组是一个国际性的、多学科的小组，旨在通过描绘手术在弥漫性成人型胶质瘤中的肿瘤学作用来标准化研究实践，该作用是根据世界卫生组织 2021 年分类定义的。更广泛的切除的有利生存效果会在数月到数十年内显现，具体取决于肿瘤的分子特征。在具有更具侵袭性自然病史的肿瘤中，最大限度切除可能与额外的生存获益相关。我们根据肿瘤的分子特征预测的切除预期生存获益与临床因素（包括神经功能缺损的引入）进行权衡，提出了一种算法来估计新诊断的胶质瘤的手术的肿瘤学效应。该算法用于选择可能从广泛切除中获益最大的患者，并强调在临床试验中量化切除范围的相关性。
