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Cited by 384

The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.

Prognostic validation of a new classification system for extent of resection in glioblastoma: A report of the RANO resect group

Open access
Karschnia, Philipp, Young, Jacob S, Dono, Antonio, Häni, Levin, Sciortino, Tommaso, Bruno, Francesco, Juenger, Stephanie T, Teske, Nico, Morshed, Ramin A, Haddad, Alexander F, Zhang, Yalan, Stoecklein, Sophia, Weller, Michael, Vogelbaum, Michael A, Beck, Juergen, Tandon, Nitin, Hervey-Jumper, Shawn, Molinaro, Annette M, Rudà, Roberta, Bello, Lorenzo, Schnell, Oliver, Esquenazi, Yoshua, Ruge, Maximilian I, Grau, Stefan J, Berger, Mitchel S, Chang, Susan M, van den Bent, Martin, Tonn, Joerg-Christian·2023·Neuro-Oncology

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 cm3) 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 cm3 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.”

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Cited by

  • Glioma

    Weller, M., Wen, P. Y., Chang, S. M., Dirven, L., Lim, M., Monje, M., & Reifenberger, G. (2024) · Nature Reviews Disease Primers · doi:10.1038/s41572-024-00516-y · Cited by 592

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Metadata

Authors
Karschnia, P., Young, J. S., Dono, A., Häni, L., Sciortino, T., Bruno, F., Juenger, S. T., Teske, N., Morshed, R. A., Haddad, A. F., Zhang, Y., Stoecklein, S., Weller, M., Vogelbaum, M. A., Beck, J., Tandon, N., Hervey-Jumper, S., Molinaro, A. M., Rudà, R., Bello, L., Schnell, O., Esquenazi, Y., Ruge, M. I., Grau, S. J., Berger, M. S., Chang, S. M., van den Bent, M., & Tonn, J.-C.
Venue
Neuro-Oncology
Published
2022-08-12
Volume
25
Issue
5
Pages
940-954
ISSN
  • 1522-8517 (ISSN-L)
  • 1523-5866
OpenAlex
W4290930135
Cited by
384
References
36
FWCI
35.22
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Prognostic validation of a new classification system for extent of resection in glioblastoma: A report of the RANO resect group. https://app.cochat.ai/papers/10.1093/neuonc/noac193
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Karschnia, P., Young, J. S., Dono, A., Häni, L., Sciortino, T., Bruno, F., Juenger, S. T., Teske, N., Morshed, R. A., Haddad, A. F., Zhang, Y., Stoecklein, S., Weller, M., Vogelbaum, M. A., Beck, J., Tandon, N., Hervey-Jumper, S., Molinaro, A. M., Rudà, R., . . . Tonn, J.-C. (2023). Prognostic validation of a new classification system for extent of resection in glioblastoma: A report of the RANO resect group. Neuro-Oncology. https://doi.org/10.1093/neuonc/noac193

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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