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Intervention Review

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Biopsy versus resection for the management of low-grade gliomas

  1. Anand Veeravagu1,
  2. Bowen Jiang2,
  3. Cassie Ludwig1,
  4. Steven D Chang1,
  5. Keith L Black3,
  6. Chirag G Patil3,*

Editorial Group: Cochrane Gynaecological, Neuro-oncology and Orphan Cancer Group

Published Online: 30 APR 2013

Assessed as up-to-date: 5 NOV 2012

DOI: 10.1002/14651858.CD009319.pub2

How to Cite

Veeravagu A, Jiang B, Ludwig C, Chang SD, Black KL, Patil CG. Biopsy versus resection for the management of low-grade gliomas. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD009319. DOI: 10.1002/14651858.CD009319.pub2.

Author Information

  1. 1

    Stanford School of Medicine, Department of Neurosurgery, Palo Alto, CA, USA

  2. 2

    Johns Hopkins Hospital, Baltimore, USA

  3. 3

    Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Los Angeles, CA, USA

*Chirag G Patil, Department of Neurosurgery, Maxine Dunitz Neurosurgical Institute, Cedars-Sinai Medical Center, 8631 West Third Street, Suite 800E, Los Angeles, CA, 90048, USA.

Publication History

  1. Publication Status: New
  2. Published Online: 30 APR 2013


This is not the most recent version of the article. View current version (27 APR 2017)


References to studies excluded from this review

  1. References to studies excluded from this review
  2. Additional references
Ahmadi 2009 {published data only}
  • Ahmadi R, Dictus C, Hartmann C, Zurn O, Edler L, Hartmann M, et al. Long-term outcome and survival of surgically treated supratentorial low-grade glioma in adult patients. Acta Neurochirurgica 2009;151(11):1359-65.
Claus 2005 {published data only}
Englot 2012 {published data only}
Jakola 2012 {published data only}
  • Jakola AS, Myrmel KS, Kloster R, Torp SH, Lindal S, Unsgard G, et al. Comparison of a strategy favoring early surgical resection vs a strategy favoring watchful waiting in low-grade glioma. JAMA 2012;308(18):1881-8.
Jung 2012 {published data only}
  • Jung TY, Jung S, Moon JH, Kim IY, Moon KS, Jang WY. Early prognostic factors related to progression and malignant transformation of low-grade gliomas. Clinical Neurology and Neurosurgery 2011;113(9):752-7.
Karim 1996 {published data only}
  •  Karim ABMF, Maat B, Hiitlevoll R, Menten J, Rutten EHJM, Thomas DGT, et al. A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European Organization for Research and Treatment of Cancer (EORTC) Study 22844. International Journal of Radiation Oncology, Biology, Physics 1996;36(3):549-56.
Laws 1984 {published data only}
Majchrzak 2012 {published data only}
  • Majchrzak K, Kaspera W, Bobek-Billewicz B, Hebda A, Stasik-Pres G, Majchrzak H, et al. The assessment of prognostic factors in surgical treatment of low-grade gliomas: A prospective study. Clinical Neurology and Neurosurgery 2012;114(8):1135-44.
Philippon 1993 {published data only}
Recht 1992 {published data only}
Sanai 2008 {published data only}
Scerrati 1996 {published data only}
  • Scerrati M, Roselli R, Lacoangeli M, Pompucci A, Rossi GF. Prognostic factors in low grade (WHO grade II) gliomas of the cerebral hemispheres: the role of surgery. Journal of Neurology, Neurosurgery, and Psychiatry 1996;61(3):291-6.
Shaw 2002 {published data only}
  • Shaw E, Arusell R, Scheithauer B, O'Fallon J, O'Neill B, Dinapoli R, et al. Prospective randomized trial of low- versus high-dose radiation therapy in adults with supratentorial low-grade glioma: initial report of a North Central Cancer Treatment Group/Radiation Therapy Oncology Group/Eastern Cooperative Oncology Group study. Journal of Clinical Oncology 2002;20(9):2267-76.
Shaw 2008 {published data only}
  • Shaw EG, Berkey B, Coons SW, Bullard D, Brachman D, Buckner JC, et al. Recurrence following neurosurgeon-determined gross-total resection of adult supratentorial low-grade glioma: results of a prospective clinical trial. Journal of Neurosurgery 2008;109(5):835-41.
Smith 2008 {published data only}
  • Smith JS, Chang EF, Lamborn KR, Chang SM, Prados MD, Cha S, et al. Role of extent of resection in the long-term outcome of low-grade hemispheric gliomas. Journal of Clinical Oncology 2008;26(8):1338-45.
van den Bent 2005 {published data only}
  • van den Bent MJ, Hassel MB, Schraub S, Hoang-Xuan K, Malmstrom PO, Collette L, et al. Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet 2005;366(9490):985-90.
van Veelen 1998 {published data only}
  • van Veelen MLC, Avezaat C, Kros J, van Putten W, Vecht C. Supratentorial low grade astrocytoma: prognostic factors, dedifferentiation, and the issue of early versus late surgery. Journal of Neurology, Neurosurgery, and Psychiatry 1998;64(5):581-7.
Vuorinen 2003 {published data only}
Whittle 2010 {published data only}
  • Whittle IR. What is the place of conservative management for adult supratentorial low-grade glioma?. Advances and Technical Standards in Neurosurgery 2010;35:65-79.
Wu 2007 {published data only}
  • Wu JS, Mao Y, Shou LF, Tang WJ, Hu J, Song YY, et al. Clinical evaluation and follow-up outcome of diffusion tensor imaging-based functional neuronavigation: a prospective, controlled study in patients with gliomas involving pyramidal tracts. Neurosurgery 2007;61(5):935-48.

Additional references

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  2. Additional references
Aaronson 1993
  • Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute 1993;85(5):365-76.
Armstrong 2006
  • Armstrong TS, Mendoza T, Gning I, Coco C, Cohen MZ, Eriksen L, et al. Validation of the M.D. Anderson Symptom Inventory Brain Tumor Module (MDASI-BT). Journal of Neuro-Oncology 2006;80(1):27-35.
Chang 2008
Deeks 2001
DerSimonian 1986
Henson 2008
Higgins 2003
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011. Available from
Jackson 2001
  • Jackson RJ, Fuller GN, Abi-Said D, Lang FF, Gokaslan ZL, Shi WM, et al. Limitations of stereotactic biopsy in the initial management of gliomas. Neuro-Oncology 2001;3(3):193-200.
Karnofsky 1949
  • Karnofsky DA, Burchenal JH. Evaluation of Chemotherapeutic Agents. In: CM Macleod editor(s). The Clinical Evaluation of Chemotherapeutic Agents in Cancer. New York: Columbia University Press, 1949:191-205.
Karnofsky 1951
  • Karnofsky DA, Burchenal JH, Armistead GC Jr, Southam CM, Bernstein JL, Craver LF, et al. Triethylene melamine in the treatment of neoplastic disease; a compound with nitrogen-mustardlike activity suitable for oral and intravenous use. Archives of Internal Medicine 1951;87:477-516.
Keles 2001
  • Keles GE, Lamborn KR, Berger MS. Low-grade hemispheric gliomas in adults: a critical review of extent of resection as a factor influencing outcome. Journal of Neurosurgery 2001 Nov;95(5):735-45.
Lote 1998
  • Lote K,  Stenwig AE,  Skullerud K,  Hirschberg H. Prevalence and prognostic significance of epilepsy in patients with gliomas. European Journal of Cancer 1998 Jan;34(1):98-102.
Lote 1998b
  • Lote K,  Egeland T,  Hager B,  Skullerud K,  Hirschberg H. Prognostic significance of CT contrast enhancement within histological subgroups of intracranial glioma. Journal of Neuro-Oncology 1998;40(2):161-70.
MacDonald 1990
Olson 2000
Omay 2012
Parmar 1998
Pignatti 2002
Pouratian 2010
Revesz 1993
  • Revesz T, Scaravilli F, Coutinho L, Cockburn H, Sacares P, Thomas DGT. Reliability of histological diagnosis including grading in gliomas biopsied by image-guided stereotactic technique. Brain 1993;116(4):781-93.
Ruiz 2009
Soffietti 2010
Taphoorn 2010
  • Taphoorn MJ, Claassens L, Aaronson NK, Coens C, Mauer M, Osoba D, et al. EORTC Quality of Life Group, and Brain Cancer, NCIC and Radiotherapy Groups. An international validation study of the EORTC brain cancer module (EORTC QLQ-BN20) for assessing health-related quality of life and symptoms in brain cancer patients. European Journal of Cancer 2010;46(6):1033-40.
Weitzner 1995
Wen 2010
  • Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, et al. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. Journal of Clinical Oncology 2010;28(11):1963-72.
Yordanova 2011
  • Yordanova YN,  Moritz-Gasser S,  Duffau H. Awake surgery for WHO Grade II gliomas within "noneloquent" areas in the left dominant hemisphere: toward a "supratotal" resection. Clinical article. Journal of Neurosurgery Aug 2011;115(2):232-9.