ArticleNeuro-oncology2023
Prognostic evaluation of re-resection for recurrent glioblastoma using the novel RANO classification for extent of resection: A report of the RANO resect group.
Article in Neuro-oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 7 of them syntheses that pooled it.
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Who cites it
68 citing papers in PubMed, 7 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Surgical treatment of recurrent glioblastoma: a multicenter perspective from the Italian society of neurosurgery (SINchNeurosurgical review · 2026Pooled it
- Determinants of survival after re-resection for recurrent glioblastoma: a meta-analysis.Acta neurochirurgica · 2026Pooled it
- EANS-EANO guidelines on the extent of resection in gliomas.Neuro-oncology · 2026Guideline
- Stereotactic radiosurgery for recurrent high-grade gliomas: a systematic review.Journal of neuro-oncology · 2025Pooled it
- Current trends in reoperation for recurrent glioblastoma: a meta-analysis (2007-2023).Journal of neuro-oncology · 2025Pooled it
- The impact of intraoperative mapping during re-resection in recurrent gliomas: a systematic review.Journal of neuro-oncology · 2025Pooled it
- Predicting glioblastoma progression using MR diffusion tensor imaging: A systematic review.Journal of neuroimaging : official journal of the American Society of NeuroimagingPooled it
- Discrepancies in inter-rater agreement on resectability of recurrent glioblastoma: Complementary post-hoc analysis of the prospective, randomized DIRECTOR trial.Neuro-oncology · 2026Trial
- The Invasive Margin of Glioblastoma as a Molecular Ecosystem: Spatial Heterogeneity, Tumor-Host Interactions, and Therapeutic Opportunities.International journal of molecular sciences · 2026Review
- Article
- Functional outcome after repeat surgery of tumor progression or treatment-associated changes in high-grade glioma: Clinical and radiological predictors.Neuro-oncology practice · 2026Article
- Salvage therapies for recurrent grade 4 IDH-wildtype glioma: a BRAIN Registry analysis of real-world treatment patterns.Journal of neuro-oncology · 2026Article
- Motor mapping to enable resections of peri-rolandic diffuse gliomas.Journal of neuro-oncology · 2026Article
- Contemporary surgical strategies for resection of intracranial gliomas.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Review
- Biology-informed risk stratification of glioblastoma by integrating MRI-based intratumoral heterogeneity with clinical features: a multicenter validation study.Experimental hematology & oncology · 2026Article
- Post-Treatment MRI Features on First Follow-Up Imaging in Diffuse Gliomas After Near-Total Resection: A Real-World Exploratory Cohort Study.Medicina (Kaunas, Lithuania) · 2026Article
- Metabolic Imaging and Molecular Signatures Reveal Metabolic Phenotypes in Recurrent Glioblastoma.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2026Article
- Laser interstitial thermal therapy versus stereotactic radiosurgery for first-time treatment of recurrent glioblastoma: a retrospective single-center study.Journal of neuro-oncology · 2026Article
- A deep learning-based model for postoperative resection assessment in glioblastoma: A comparative study.Neurosurgical review · 2026Article
- Two-Stage Surgery in Patients with Diffuse Glioma-Indications, Implications and Outcome.Cancers · 2026Article
8 more citing papers are in PubMed but not listed here.
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27 authors at 11 institutions in 5 countries.
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Abstract
backgroundThe value of re-resection in recurrent glioblastoma remains controversial as a randomized trial that specifies intentional incomplete resection cannot be justified ethically. Here, we aimed to (1) explore the prognostic role of extent of re-resection using the previously proposed Response Assessment in Neuro-Oncology (RANO) classification (based upon residual contrast-enhancing (CE) and non-CE tumor), and to (2) define factors consolidating the surgical effects on outcome.
methodsThe RANO resect group retrospectively compiled an 8-center cohort of patients with first recurrence from previously resected glioblastomas. The associations of re-resection and other clinical factors with outcome were analyzed. Propensity score-matched analyses were constructed to minimize confounding effects when comparing the different RANO classes.
resultsWe studied 681 patients with first recurrence of Isocitrate Dehydrogenase (IDH) wild-type glioblastomas, including 310 patients who underwent re-resection. Re-resection was associated with prolonged survival even when stratifying for molecular and clinical confounders on multivariate analysis; ≤1 cm3 residual CE tumor was associated with longer survival than non-surgical management. Accordingly, "maximal resection" (class 2) had superior survival compared to "submaximal resection" (class 3). Administration of (radio-)chemotherapy in the absence of postoperative deficits augmented the survival associations of smaller residual CE tumors. Conversely, "supramaximal resection" of non-CE tumor (class 1) was not associated with prolonged survival but was frequently accompanied by postoperative deficits. The prognostic role of residual CE tumor was confirmed in propensity score analyses.
conclusionsThe RANO resect classification serves to stratify patients with re-resection of glioblastoma. Complete resection according to RANO resect classes 1 and 2 is prognostic.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.