Evidence map›Paper›PMID 41811545›Full record

Observational studyJournal of neuro-oncology2026

Prognostic relevance of resection at first recurrence in isocitrate dehydrogenase mutant lower-grade glioma: results from a retrospective, single-center, volumetric analysis.

Christine Jungk, Karla Goepfert, Mara Gluszak, Karim Marhaba, Philip Dao Trong, Sandro M Krieg, Martin Bendszus, Felix Sahm, Andreas W Unterberg

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Christine JungkDepartment of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany. christine.jungk@icloud.com.ORCID http://orcid.org/0009-0004-7911-0268
Karla GoepfertDepartment of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
Mara GluszakDepartment of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
Karim MarhabaDepartment of Neuropathology, Heidelberg University Hospital, Im Neuenheimer Feld 224, D-69120, Heidelberg, Germany.
Philip Dao TrongDepartment of Neurosurgery, Medical Faculty, Heidelberg University, D-69120, Heidelberg, Germany.
Sandro M KriegDepartment of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
Martin BendszusDepartment of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
Felix SahmDepartment of Neuropathology, Heidelberg University Hospital, Im Neuenheimer Feld 224, D-69120, Heidelberg, Germany.
Andreas W UnterbergDepartment of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe prognostic role of repeat resection in IDH-mutant lower-grade glioma remains insufficiently defined. This observational single-center study investigated whether resection at 1st recurrence was associated with (progression-free) survival after recurrence (PFS-2; SAR) and evaluated functional outcomes.

methodsWe retrospectively analyzed 148 molecularly characterized IDH-mutant astrocytoma and oligodendroglioma patients, WHO grade 2 and 3, undergoing resection (n = 50) or non-surgical treatment (n = 98) at 1st recurrence between 2001 and 2023. In surgical cases, FLAIR tumor volumes (TV) were assessed volumetrically. Prognostic factors were identified by log-rank tests and multivariable Cox proportional hazards regression. Median follow-up was 140 months.

resultsFemale sex (p = 0.005), frontal tumors (p = 0.029) and iterative resections (p = 0.025) were more frequent in surgical patients, while non-surgical patients received more systemic treatment. Functional status (KPS, NANO) and tumor characteristics (histology, WHO grade) were balanced. In multivariable analysis, re-resection was associated with prolonged PFS-2 (p = 0.029, HR = 0.560, 95% CI 0.332–0.944), but not with SAR. In surgical cases, median pre- and postoperative TVs were 19.75 cm3 and 4.545 cm3 (p < 0.00001). PFS-2 was significantly prolonged in patients without (n = 12) compared to surgical patients with residual TV (n = 38; p = 0.022) and all patients with residual disease, including non-surgical cases (n = 136; p = 0.007). Following re-resection, a permanent deficit remained in 1 patient (2%). Functional status was preserved, with stable rates of KPS ≥90% and NANO = 0 at 7 days and 3 months postoperatively.

conclusionIn this cohort of IDH-mutant lower-grade gliomas, repeat resection at 1st recurrence was safe and associated with prolonged PFS-2, especially when GTR was achieved, supporting its relevance in multimodal treatment.

Indexed as

Brain NeoplasmsGliomaIsocitrate DehydrogenaseMutationNeoplasm Recurrence, LocalNeurosurgical ProceduresAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm GradingPrognosisRetrospective StudiesIDH1 protein, humanIsocitrate DehydrogenaseFunctional outcomeIDH mutationLower-grade gliomaRepeat resectionSurvivalTumor volumetry

Identifiers

PMID41811545
PMCPMC12979295

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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.