AANS/CNS SECTION
ON TUMORS

 

The Section on Tumors’ Guidelines Committee has had a very busy summer; we are looking forward to the release and publication of two major guidelines projects in the next few months, and we will also be generating new guidelines topics at our fall meeting to continue to address critical knowledge and practice gaps in our professions.

 

The progressive/recurrent glioblastoma guidelines project, expertly led by Jeffrey Olson, MD, FAANS, along with Timothy Ryken, MD, FAANS, and with major support from Laura Mitchell and the Congress of Neurological Surgeons’ (CNS) National Guidelines Committee, recently completed the formal review process in organized neurosurgery and has just received final approval and endorsement from the AANS/CNS Joint Guidelines Committee (JGC). We would like to thank the senior authors of each of the major chapters for spearheading such a multifaceted and comprehensive analysis of the current and near-future state of recurrent glioblastoma multiforme (GBM) treatment, including Dr. Ryken, Dr. Olson, Daniel Brat, MD, PhD; Samuel Ryu, MD; Patrick Wen, MD; Lakshmi Nayak, MD; John Buatti, MD; and Johnathan Morris, MD, as well as many others in our writing groups from the Section and also from our multidisciplinary collaborations in radiation oncology, medical oncology, neuro-oncology, neuroradiology, and neuropathology.

 

This guideline initiative focuses on the difficult questions asked in tumor boards across the country: What is the best way to treat GBM at recurrence? Specific chapters address the following questions in the clinical management and treatment of progressive GBM: Outcome Assessment and Neurocognition; Role of Neuro-imaging (progression vs. radiation change); Role of Biopsy; Role of Repeat Cytoreductive Surgery; Role of Radiotherapy Techniques (re-irradiation, stereotactic radiosurgery, brachytherapy); Role of Chemotherapy; and Future Innovations. We anticipate publication in the Journal of Neuro-oncology in early 2014, and we would especially like to acknowledge editor Linda Liau, MD, PhD, FAANS, for agreeing to expedite the publication of these guidelines once approved by the JGC and our national parent organizations, the American Association of Neurological Surgeons and the CNS.

 

Our newest effort, also spearheaded by Dr. Olson, focuses on the clinical practice guidelines for low-grade glioma. Along with Dr. Olson, this effort is being co-led by Mark Linskey, MD, FAANS; Dr. Ryken and I, with many of our Section on Tumors executive committee members also playing a leading role in the various chapters: Role of Imaging (Sarah Jost Fouke, MD, FAANS), Role of Biopsy (Brian Ragel, MD, FAANS), Role of Surgical Resection (Manish Aghi, MD, FAANS), Neuropathology and Molecular Markers (Daniel Cahill, MD, PhD, FAANS), Role of Radiation (Ian Parney, MD, PhD), Role of Chemotherapy (Mateo Ziu, MD), Options for Recurrent Low-grade Glioma (Brian Nahed, MD) and Emerging Therapies for LGG (Andrew Sloan, MD, FAANS). The initial writing stage has already been completed, and the project currently is going through the first review stages, with an anticipated submission date to the JGC by the end of this calendar year.

 

We welcome all participants, and anyone interested in working on guidelines projects is strongly encouraged to contact Steven N. Kalkanis MD, FAANS, at skalkan1@hfhs.org.