M, van den Bent M, Tonn JC, Stupp R, Preusser M,
Cohen-Jonathan-Moyal E, Henriksson R, Rhun EL, Balana C, Chinot O,
Bendszus M, Reijneveld JC, Dhermain F, French P, Marosi C, Watts
C, Oberg I, Pilkington G, Baumert BG, Taphoorn MJB, Hegi M,
Westphal M, Reifenberger G, Soffietti R, Wick W; European
Association for Neuro-Oncology (EANO) Task Force on Gliomas.
management of adult patients with diffuse glioma - Authors' reply.
Oncol. 2017 Aug;18(8):e430-e431. doi:
10.1016/S1470-2045(17)30515-6. Epub 2017 Jul 26.
colleagues miss a specific reference to the value of radiological
we did not think that the assessment of tumour growth by
neuroimaging was important, we would not have recommended regular
MRI scanning to determine benefit from treatment and the need for
no prospective systematic outcome study informs us on how to
integrate radiological growth rates into clinical decision making,
notably about timepoints of interventions.
our colleagues are at odds with our assessment of the scientific
literature on the role of surgery for adult patients with glioma.
our assessment of the evidence, which is a result of
multi-disciplinary consensus involving leading neurosurgeons in
Europe, is fully consistent with the current Cochrane review,
reinforces the need for randomised controlled clinical trials in
agree that the recent long-term follow-up on the Norwegian cohort
study is suggestive of a benefit of early surgical intervention in
patients with low grade gliomas across the major molecular
might in fact be the best evidence for a role of early surgery in
this population published so far.
this cohort study cannot be considered as conclusive evidence
about the value of resection.
the article was not available in the public domain when we
prepared the EANO guideline.
it is incorrect to state that cognitive function and quality of
life assessments are not mentioned: they are in fact mentioned as
part of the clinical examination.
this was not the main scope of this guideline and the importance
of cognitive function and quality of life in the overall
management strategies for adult patients with glioma has recently
been addressed in a separate EANO guideline.