title: Repeat surgery for recurrent low-grade gliomas should be standard of care.
abstract: The importance of surgery and maximal extent of resection (EOR) is well established in primary low-grade glioma (LGG) management. However, the role of surgery in the management of recurrent LGG is less clear. A recent review on the management of recurrent LGG concluded there was insufficient evidence to recommend surgery. Here, we summarize the recent advances regarding the role of surgery, radiotherapy (RT) and chemotherapy in the management of recurrent LGG. There is increasing evidence to support maximal EOR for treating recurrent LGG, as it may improve progression free survival (PFS) after recurrence and overall survival (OS). Based on the studies presented in this review, we suggest that repeat surgery with maximal EOR should be standard of care for recurrent LGG treatment.
authors.affiliation: Department of Neurological Surgery, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10021, United States. Electronic address: tju2001@med.cornell.edu.
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: Uppstrom
authors.affiliation: Department of Neurological Surgery, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10021, United States. Electronic address: ras2053@med.cornell.edu.
authors.forename: Ranjodh
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Neurosurgery, Red Cross Hospital, Athanasaki 1 & Erithrou Stavrou, Athens, Greece. Electronic address: georgehadji@gmail.com.
authors.forename: Georgios F
authors.initials: GF
authors.lastname: Hadjigeorgiou
authors.affiliation: Department of Neurology, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10021, United States. Electronic address: magger@mskcc.org.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Magge
authors.affiliation: Department of Neurological Surgery, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10021, United States. Electronic address: ror9068@med.cornell.edu.
authors.forename: Rohan
authors.initials: R
authors.lastname: Ramakrishna
mesh_terms: D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D005910:Glioma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000592:standards*; D012086:Reoperation / Q000592:standards*; D059039:Standard of Care / Q000592:standards*
keywords: Chemotherapy; Extent of resection; Low grade glioma; Radiotherapy; Recurrent low-grade glioma