ArticleJournal of neuro-oncology2025
Assessment of the RANO-resect criteria in elderly patients with glioblastoma.
Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Nationwide Analysis of Initial Surgical Management for Newly Diagnosed Glioblastoma in Japan (2018-2023): Part 1. Regional Practice Patterns in an Aging Society.Neurologia medico-chirurgica · 2026Article
- Population-based validation of the RANO categories for extent of resection in glioblastoma.Neuro-oncology advancesArticle
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionElderly patients with IDH-wild type glioblastoma (IDH-WT GBM) have a dismal prognosis compared to younger patients. Given the prognostic relevance of extent of resection (EOR), we aimed to assess the prognostic utility of the Response Assessment in Neuro-Oncology (RANO)-resect classification in this population.
methodsWe retrospectively analyzed patients ≥ 65 years who underwent resection for newly diagnosed IDH-WT GBM between 2005 and 2023. EOR was categorized per RANO-resect classifications based on volumetric MRI analysis.
resultsAmong 147 patients, 54 (36.7%) had Class 1 and 2 resection, 70 (47.6%) had Class 3 resection, and 23 (15.6%) underwent biopsy. The incidence of postoperative neurological and non-neurological complications was comparable across RANO-resect classes. Median overall survival (OS) was significantly longer for Class 1 and 2 resection (16.0 months, 95% CI: 10.4-21.7) versus Class 3 (10.6 months, 95% CI: 9.1-12.1) and biopsy (8.8 months, 95% CI: 4.0-13.5) (p = 0.033). Progression-free survival (PFS) did not differ between groups. Notably, in the adjuvant chemoradiotherapy sensitivity analysis, categorical RANO-resect classes showed no OS differences, but residual CE tumor volume remained independently prognostic of OS (HR = 1.006; 95% CI: 1.001-1.010; p = 0.010).
conclusionWhile greater EOR within RANO-resect classes correlated with improved OS and similar safety, adjuvant chemoradiotherapy sensitivity analyses showed no categorical OS differences. However, residual CE tumor volume remained independently prognostic of survival. Further studies are needed to clarify the role of surgery in elderly IDH-WT GBM patients.
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