Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for the Treatment of Adults With WHO Grade II Diffuse Glioma: Update

BACKGROUND: The management of World Health Organization (WHO) grade II diffuse glioma is an important facet of all physicians involved in neuro-oncology. OBJECTIVE: This is an update of the evidence-based guidelines for management of WHO grade II diffuse gliomas published by the Congress of Neurological Surgeons and American Association of Neurological Surgeons in 2015. METHODS: The medical literature from January 1, 2013, through January 31, 2020, was searched to determine if information was available to update, modify, or create new recommendations related to imaging, surgical approaches, neuropathology and molecular markers, radiotherapy, chemotherapy, and management of tumor recurrence. RESULTS: The writing group used the information from the updated literature search to formulate recommendations based on this evidence and not simply built on biased consensus or expert opinion. CONCLUSION: This series of guideline documents provides an update of the information and recommendations provided in the 2015 version. It sets a benchmark as to the published information we have to support the management of this difficult disease. It also provides clues to key investigations that are necessary to move us toward effective control of WHO grade II diffuse gliomas.