The role for surgery in IDH-mutant grade 4 Astrocytomas: interactive effects of resection, patient characteristics, and outcome - report of the RANO resect group

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ID: 327110
2026
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Abstract
Lay Summary Surgery is the first step in treating patients with the rare brain tumor IDH-mutant grade 4 astrocytoma. In an international study of 266 patients, we examined how the amount of tumor remaining after surgery affects survival. Patients with less remaining contrast-enhancing tumor lived longer. Those who underwent ‘supramaximal’ surgery (tumor removal beyond the visible enhancing portion) had the most favorable outcomes. Loss of the CDKN2A/B gene was linked to worse survival regardless of the extent of surgery. These findings suggest that removing as much enhancing tumor as safely possible may improve outcomes and guide risk stratification in future clinical trials.
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Authors Philipp Karschnia, Gilbert Youssef, Jacob S Young, Nico Teske, Maarten M J Wijnenga, Antonio Dono, Okizeva Rapi, Yae Won Park, Arthur Wagner, Tommaso Sciortino, Francesco Bruno, Levin Häni, Felix Ehret, Nicolas Neidert, Einar O Vik-Mo, Roland Goldbrunner, Juergen Beck, Andreas Raabe, Roberta Rudà, Lorenzo Bello, Bernhard Meyer, Sung Soo Ahn, Asgeir S Jakola, Yoshua Esquenazi, Martin van den Bent, Shawn Hervey-Jumper, Mitchel S Berger, Patrick Y Wen, Oliver Schnell, Joerg-Christian Tonn, Rano resect group, Stephanie T Juenger, Eduardo E Mendoza Mireles, Alfred Gramelt, Raymond Y. Huang, Annette M Molinaro, Alexander A. Aabedi, Susan M Chang, Thijs van der Vaart, Arnaud J P E Vincent, Nitin Tandon, Michael Weller, Jong Hee Chang, Marco Rossi, Marco Conti Nibali, Alberto Gallotti, Daniel P. Cahill, Stefan Grau, Florian Ringel, Michael A Vogelbaum, Jorg Dietrich
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Journal journal of neuro-oncology
Year 2026
DOI
10.1093/neuonc/noag199
URL
https://doi.org/10.1093/neuonc/noag199
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