ASCO 2023 | Prognostic evaluation of re-resection in recurrent glioblastoma: RANO classification report

Philipp Karschnia, MD, Ludwig-Maximilians-University, Munich, Germany, discusses a prognostic evaluation of surgical re-resection for recurrent glioblastoma using the novel RANO classification for extent of resection.The cohort included 681 IDH-wildtype glioblastoma patients, with 310 undergoing re-resection at first recurrence. Re-resection was associated with prolonged survival, even when adjusting for molecular and clinical confounders. Residual contrast-enhancing (CE) tumor volume had a significant impact on survival, with ≤1 cm3 residual CE tumor leading to improved survival compared to non-surgical management. “Maximal resection” (class 2) showed superior survival compared to “submaximal resection” (class 3). Adjuvant chemotherapy further enhanced the beneficial effects of lower residual CE tumor. However, “supramaximal resection” of non-CE tumor (class 1) did not improve survival and was associated with post-operative deficits. The study suggests that the RANO resect classification may help stratify patients for prognosis and guide treatment decisions in recurrent glioblastoma. This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

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