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Cited by 303Glioma Diagnosis and TreatmentMeningioma and schwannoma managementSarcoma Diagnosis and Treatment

The WHO 2021 Classification of Central Nervous System tumours: a practical update on what neurosurgeons need to know—a minireview

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Torp, Sverre Helge, Solheim, Ole, Skjulsvik, Anne Jarstein·2022·Acta Neurochirurgica
DOI 10.1007/s00701-022-05301-yPMC PMC9427889
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Abstract

Background: The World Health Organization (WHO) Classification of Tumours, also known as WHO Blue Books, represents an international standardised tool in the diagnostic work-up of tumours. This classification system is under continuous revision, and progress in the molecular classification of tumours in the central nervous system (CNS) enforced an update of the WHO 2016 classification, and the fifth edition, WHO CNS5, was published in 2021. The aim of this minireview is to highlight important changes in this new edition relevant for the practicing neurosurgeon. Methods: The sixth volume of the fifth edition of the WHO Blue Books of CNS tumours and related papers formed the basis for this minireview. Results: Major changes encompass standardisation of tumour grading and nomenclature as well as increased incorporation of molecular markers in the classification of CNS tumours. Conclusion: Advances in molecular genetics have resulted in more accurate diagnosis and prognosis of CNS tumours, and this minireview summarises important changes implemented in the last edition of WHO classification of CNS tumours important for the practicing neurosurgeon.

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  • The latest WHO CNS5 2021 glioma tumor classification emphasizes the use of genetic alterations in IDH, ATRX, Ki-67, and p53 in association with glioma patient overall survival.

    “The latest WHO CNS5 2021 glioma tumor classification emphasizes the use of genetic alterations in IDH, ATRX, Ki-67, and p53 in association with glioma patient overall survival.”

    From miR-21 as a diagnostic and prognostic biomarker in glioma: tissue and serum expression analysis in a Pakistani cohort (2026) · cites this paper as [2]

    In “Specific tumour updates > Gliomas, glioneuronal and neuronal tumours” (page unavailable), Table 5 links IDH mutations to better prognosis, and the discussion uses ATRX and TP53 findings in glioma diagnosis. It does not link ATRX or TP53 alterations to overall survival; it describes Ki-67 as a proliferative index, not a genetic alteration, and says it lacks a reliable threshold for risk stratification. The claim therefore overstates the role of these four markers in relation to overall survival. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • IDH, ATRX, Ki-67, and p53 markers are significantly associated with disease prognosis and play a crucial role in designing treatment strategies for better glioma outcomes.

    “These markers are significantly associated with disease prognosis and play a crucial role in designing treatment strategies for better glioma outcomes [2].”

    From miR-21 as a diagnostic and prognostic biomarker in glioma: tissue and serum expression analysis in a Pakistani cohort (2026) · cites this paper as [2]

    In ‘Gliomas, glioneuronal and neuronal tumours’ (page not provided), Table 5 associates IDH mutations with better prognosis, and the text says Ki-67 increases with tumour grade. But it says Ki-67 has no reliable threshold for identifying patients at increased risk of recurrence; it presents ATRX and TP53 chiefly as diagnostic markers, not as prognostic markers. The paper does not establish that these four markers guide treatment strategies to improve glioma outcomes. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Torp, S. H., Solheim, O., & Skjulsvik, A. J.
Affiliations
Norwegian University of Science and Technology (NO)
Corresponding author
Torp, Sverre Helge
ORCID
Venue
Acta Neurochirurgica
Publisher
Springer Science and Business Media LLC
Published
2022-07-26
Volume
164
Issue
9
Pages
2453-2464
ISSN
  • 0001-6268 (ISSN-L)
  • 0942-0940
DOI
10.1007/s00701-022-05301-y
PMC
PMC9427889
OpenAlex
W4287831693
Cited by
303
References
1
Citations by year
2026: 71 · 2025: 93 · 2024: 94 · 2023: 40 · 2022: 5
FWCI
9.74
Type
journal article
Language
en
Open access
Licence
Locations
  • Acta Neurochirurgica (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
Funders
NTNU Norwegian University of Science and Technology
Topics
  • Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
  • Health Sciences › Medicine › Epidemiology › Meningioma and schwannoma management
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
Keywords
central nervous system tumors, tumour grading, tumor nomenclature, molecular markers, molecular classification, neurosurgery
MeSH terms
Neurosurgeons, Humans, World Health Organization, Central Nervous System Neoplasms

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