title: Astrocytic gliomas WHO grades II and III.
abstract: World Health Organization grades II and III lower-grade astrocytomas are a challenging area in neuro-oncology. One the one hand, for proper diagnosis, the analysis of molecular factors, especially mutation status of isocitrate dehydrogenase and 1p/19q status in the tumor status needs to be done in addition to classical neuropathology. Further, the high clinical and prognostic value of a maximal safe resection requires a profound knowledge of presurgical diagnosis and surgical as well as imaging techniques to ensure optimal outcome for patients. Also medical treatment may be more intensive than previously believed, with randomized trials providing evidence for a benefit in overall survival by combined chemoradiation versus radiation alone. A critical problem concerns the considerable undesirable effects of therapeutic interventions on long-term health-related quality of life, cognitive and functional outcome as well as future developments in this still difficult disease that will need to be addressed in future trials.
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, CA, USA. Electronic address: bergerm@neurosurg.ucsf.edu.
authors.forename: Mitchel S
authors.initials: MS
authors.lastname: Berger
authors.affiliation: Department of Neurological Surgery, Taubman Health Center, Ann Arbor, MI, USA.
authors.forename: Shawn
authors.initials: S
authors.lastname: Hervey-Jumper
authors.affiliation: Department of Neurooncology, University Clinic of Heidelberg, Heidelberg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wick
mesh_terms: D001254:Astrocytoma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001932:Brain Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D002872:Chromosome Deletion; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics; D009154:Mutation / Q000235:genetics; D059906:Neuroimaging; D057089:Pathology, Molecular; D014944:World Health Organization
chemical_list: D007521:Isocitrate Dehydrogenase
keywords: 1p/19q co-deletion; MGMT; TERT; awake craniotomy; isocitrate dehydrogenase (IDH); molecular classification