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Practice Guideline
. 2019 Jan-Feb;67(1):173-182.
doi: 10.4103/0028-3886.253572.

ISNO consensus guidelines for practical adaptation of the WHO 2016 classification of adult diffuse gliomas

Vani Santosh  1 , Palavalasa Sravya  2 , Tejpal Gupta  3 , Dattatraya Muzumdar  4 , Geeta Chacko  5 , Vaishali Suri  6 , Sridhar Epari  7 , Anandh Balasubramaniam  8 , Bishan Dass Radotra  9 , Sandip Chatterjee  10 , Chitra Sarkar  6 , Rakesh Jalali  11
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Free article
Practice Guideline

ISNO consensus guidelines for practical adaptation of the WHO 2016 classification of adult diffuse gliomas

Vani Santosh et al. Neurol India. 2019 Jan-Feb.
Free article

Abstract

Introduction: Recent advances in the molecular biology of adult diffuse gliomas have brought about a paradigm shift in their diagnostic criteria, as witnessed in the World Health Organization (WHO) 2016 guidelines for central nervous system tumors. It is now mandatory to perform several molecular tests to reach a definitive integrated diagnosis in most of the cases. This comes with additional cost and higher turnaround time, which is not always affordable in developing countries like India. In addition, the non-uniform distribution of advanced research and diagnostic testing centers adds to the difficulty.

Methods: The Indian Society of Neuro-oncology (ISNO) multidisciplinary expert panel consisting of neuropathologists, neurosurgeons, and radiation/medical oncologists convened to prepare the national consensus guidelines for approach to diagnosis of adult diffuse gliomas.

Results: Algorithms for arriving at an integrated diagnosis of adult diffuse gliomas predominantly using immunohistochemistry and with minimum possible additional molecular testing were agreed upon, thus addressing the problems of cost, accessibility, and turnaround time. Mandatory and optional tests were proposed for each case scenario.

Conclusion: This document represents the consensus of the various neuro-oncology disciplines involved in diagnosis and management of patients with adult diffuse gliomas. The article reflects a practical adaptation of the WHO recommendations to suit a resource constrained setup.

Keywords: Consensus guidelines; diagnosis; diffuse glioma; management.

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