About this trial

There are no guidelines or prospective studies defining the optimal surgical treatment for gliomas of older patients (≥70 years) or those with limited functioning performance at presentation (KPS ≤70). Therefore, the decision between resection and biopsy is varied, amongst neurosurgeons internationally and at times even within an instiutition. This study aims to compare the effects of maximal tumor resection versus tissue biopsy on survival, functional, neurological, and quality of life outcomes in these patient subgroups. Furthermore, it evaluates which modality would maximize the potential to undergo adjuvant treatment.

This study is an international, multicenter, prospective, 2-arm cohort study of observational nature. Consecutive HGG patients will be treated with resection or biopsy at a 3:1 ratio. Primary endpoints are: 1) overall survival (OS) and 2) proportion of patients that have received adjuvant treatment with chemotherapy and radiotherapy. Secondary endpoints are 1) proportion of patients with NIHSS (National Institute of Health Stroke Scale) deterioration at 6 weeks, 3 months and 6 months after surgery 2) progression-free survival (PFS); 3) quality of life at 6 weeks, 3 months and 6 months after surgery and 4) frequency and severity of Serious Adverse Events (SAEs). Total duration of the study is 5 years. Patient inclusion is 4 years, follow-up is 1 year.

Eligibility criteria

Qualifiers

Age ≥18 years and ≤90 years

Tumor diagnosed as HGG (WHO grade III/IV) on MRI as assessed by the neurosurgeon

Written informed consent

Disqualifiers

Tumors of the cerebellum, brainstem or midline

Medical reasons precluding MRI (e.g. pacemaker)

Inability to give written informed consent

Secondary high-grade glioma due to malignant transformation from low-grade glioma

Trial design

Treatments tested in this trial

  • Tumor resection
  • Tumor biopsy

Treatment groups

564 Participants
are divided into 2 treatment groups

Locations

8
Belgium
University Hospital Leuven Leuven Belgium
Germany
Technical University Munich74076, MunichBavaria, Germany
University Hospital Heidelberg Heidelberg Germany
Netherlands
Erasmus Medical Center3015 GD, RotterdamSouth Holland, Netherlands

Sponsors and collaborators

Jasper Gerritsen

Lead sponsor

Erasmus Medical Center

Sponsor institution

Haaglanden Medical Centre

Collaborator

Universitaire Ziekenhuizen KU Leuven

Collaborator

University Hospital Heidelberg

Collaborator

Technical University of Munich

Collaborator

Insel Gruppe AG, University Hospital Bern

Collaborator

Massachusetts General Hospital

Collaborator

University of California, San Francisco

Collaborator