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WHO II and III Gliomas

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Oncology of CNS Tumors

Abstract

Over 70,000 patients are diagnosed each year with a glioma. Prognosis and response to chemoradiation are determined by balanced translocations between chromosomes 1p and 19q in addition to the presence of mutations within isocitrate dehydrogenase 1 or 2 genes. WHO II and III gliomas are therefore subclassified according to both histopathology and molecular characterization. Regardless of tumor type, the first step in management remains surgical resection. It has been well established that greater extent of tumor resection impacts both overall and progression-free survival. Maximal resection can be difficult to achieve due to tumor proximity to eloquent structures and uncertainty as to tumor margins. Direct stimulation mapping, functional neuronavigation, and intraoperative MRI are all useful tools to improve extent of tumor resection while minimizing morbidity. Alkylating chemotherapy in addition to radiation therapy is used to improve survival for high-risk patient populations. This chapter is focused on the management of WHO II and III gliomas including strategies such as cytoreduction surgery, radiotherapy, and chemotherapy.

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Authors and Affiliations

  1. Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA

    Shawn L. Hervey-Jumper & Mitchel S. Berger

  2. Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, the Netherlands

    M. J. van de Bent

  3. Miami Cancer Institute, Baptist Hospital, Miami, FL, USA

    Minesh P. Mehta

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  1. Shawn L. Hervey-Jumper
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  2. M. J. van de Bent
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  3. Minesh P. Mehta
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  4. Mitchel S. Berger
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  1. Department of Neurosurgery, University of Munich Department of Neurosurgery, Munich, Germany

    Jörg-Christian Tonn

  2. Dana-Farber Cancer Institute Center, Harvard University, Boston, USA

    David A. Reardon

  3. SickKids Hospital, University of Toronto, Toronto, ON, Canada

    James T. Rutka

  4. Department of Neurosurgery, University of Hamburg, Hamburg, Germany

    Manfred Westphal

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Hervey-Jumper, S.L., van de Bent, M.J., Mehta, M.P., Berger, M.S. (2019). WHO II and III Gliomas. In: Tonn, JC., Reardon, D., Rutka, J., Westphal, M. (eds) Oncology of CNS Tumors. Springer, Cham. https://doi.org/10.1007/978-3-030-04152-6_9

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