This guideline was prepared by a task force nominated by the Executive Board of the European Association for Neuro-Oncology (EANO) in cooperation with the Brain Tumor Group of the European Organisation for Research and Treatment of Cancer in 2016. The task force represents the disciplines involved in the diagnosis and care of patients with glioma and reflects the multinational character of EANO. We used PubMed and the search terms “glioma”, “anaplastic”, “astrocytoma”, “oligodendroglioma”,
ReviewEuropean Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas
Introduction
The European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas follows the revision of the fourth edition of WHO classification of tumours of the central nervous system1 and builds on previous guidelines.2, 3 The guideline covers adult astrocytic and oligodendroglial gliomas of WHO grades II–IV, including glioblastomas, and variants of these tumours, and discusses prevention, early diagnosis and screening, histological and molecular diagnostics, therapy, and follow-up. However, the guideline does not address differential diagnosis, adverse effects of treatment, or supportive or palliative care.
Section snippets
Prevention, early diagnosis, and screening
The annual incidence of gliomas, including glioblastoma, is around six cases per 100 000 individuals worldwide. Serum markers for early detection have not been identified. Brain MRI has the highest sensitivity for the detection of small tumours. Gliomas can evolve rapidly over several weeks or months, presenting challenges for population-based prevention or early intervention. Screening is therefore limited to individuals at genetic risk—eg, patients with neurofibromatosis type I, Turcot
Prognostic factors
Younger age and better performance status are important positive, therapy-independent prognostic factors across glioma entities, and extent of resection is an important therapy-dependent prognostic factor (figure 2). Molecular markers that favour longer survival, such as IDH mutation and 1p/19q codeletion, are now at the core of the WHO classification and define more homogeneous diagnostic and prognostic entities.1, 26
Surgical therapy
Beyond a histological diagnosis, the goal of surgery is to remove as much of
Search strategy and selection criteria
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