Karschnia, Philipp ORCID: 0000-0002-1254-5310, Young, Jacob S., Dono, Antonio ORCID: 0000-0002-8041-8399, Haeni, Levin, Sciortino, Tommaso, Bruno, Francesco ORCID: 0000-0001-8087-5293, Juenger, Stephanie T., Teske, Nico, Morshed, Ramin A., Haddad, Alexander F., Zhang, Yalan, Stoecklein, Sophia, Weller, Michael ORCID: 0000-0002-1748-174X, Vogelbaum, Michael A., Beck, Juergen, Tandon, Nitin, Hervey-Jumper, Shawn, Molinaro, Annette M., Ruda, Roberta, Bello, Lorenzo, Schnell, Oliver, Esquenazi, Yoshua, Ruge, Maximilian, I, Grau, Stefan J., Berger, Mitchel S., Chang, Susan M., van den Bent, Martin and Tonn, Joerg-Christian . Prognostic validation of a new classification system for extent of resection in glioblastoma: A report of the RANO resect group. Neuro-Oncology. CARY: OXFORD UNIV PRESS INC. ISSN 1523-5866

Full text not available from this repository.

Abstract

Background Terminology to describe extent of resection in glioblastoma is inconsistent across clinical trials. A surgical classification system was previously proposed based upon residual contrast-enhancing (CE) tumor. We aimed to (1) explore the prognostic utility of the classification system and (2) define how much removed non-CE tumor translates into a survival benefit. Methods The international RANO resect group retrospectively searched previously compiled databases from 7 neuro-oncological centers in the USA and Europe for patients with newly diagnosed glioblastoma per WHO 2021 classification. Clinical and volumetric information from pre- and postoperative MRI were collected. Results We collected 1,008 patients with newly diagnosed IDHwt glioblastoma. 744 IDHwt glioblastomas were treated with radiochemotherapy per EORTC-26981/22981 (TMZ/RT -> TMZ) following surgery. Among these homogenously treated patients, lower absolute residual tumor volumes (in cm(3)) were favorably associated with outcome: patients with maximal CE resection (class 2) had superior outcome compared to patients with submaximal CE resection (class 3) or biopsy (class 4). Extensive resection of non-CE tumor (<= 5 cm(3) residual non-CE tumor) was associated with better survival among patients with complete CE resection, thus defining class 1 (supramaximal CE resection). The prognostic value of the resection classes was retained on multivariate analysis when adjusting for molecular and clinical markers. Conclusions The proposed RANO categories for extent of resection in glioblastoma are highly prognostic and may serve for stratification within clinical trials. Removal of non-CE tumor beyond the CE tumor borders may translate into additional survival benefit, providing a rationale to explicitly denominate such supramaximal CE resection.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Karschnia, PhilippUNSPECIFIEDorcid.org/0000-0002-1254-5310UNSPECIFIED
Young, Jacob S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dono, AntonioUNSPECIFIEDorcid.org/0000-0002-8041-8399UNSPECIFIED
Haeni, LevinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sciortino, TommasoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruno, FrancescoUNSPECIFIEDorcid.org/0000-0001-8087-5293UNSPECIFIED
Juenger, Stephanie T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Teske, NicoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morshed, Ramin A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haddad, Alexander F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zhang, YalanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stoecklein, SophiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weller, MichaelUNSPECIFIEDorcid.org/0000-0002-1748-174XUNSPECIFIED
Vogelbaum, Michael A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Beck, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tandon, NitinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hervey-Jumper, ShawnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Molinaro, Annette M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruda, RobertaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bello, LorenzoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schnell, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Esquenazi, YoshuaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruge, Maximilian, IUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grau, Stefan J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berger, Mitchel S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chang, Susan M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van den Bent, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tonn, Joerg-ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-694565
DOI: 10.1093/neuonc/noac193
Journal or Publication Title: Neuro-Oncology
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1523-5866
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
GLIOMAS RESPONSE ASSESSMENT; ADJUVANT TEMOZOLOMIDE; PHASE-III; SURVIVAL; RADIOTHERAPY; CONCOMITANT; SURGERY; BENEFIT; VOLUMEMultiple languages
Oncology; Clinical NeurologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69456

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item