Repeat surgery for recurrent low-grade gliomas should be standard of care

- Based on prior reviews, the role of surgery in managing recurrent LGG is uncertain.
- There is increasing evidence to support maximal EOR for treatment of recurrent LGG.
- Maximal EOR for recurrent LGG may increase OS and PFS after recurrence.
- We suggest that surgery (maximal EOR) should be standard of care for recurrent LGG.

The importance of surgery and maximal extent of resection (EOR) is well established in primary low-grade glioma (LGG) management. However, the role of surgery in the management of recurrent LGG is less clear. A recent review on the management of recurrent LGG concluded there was insufficient evidence to recommend surgery. Here, we summarize the recent advances regarding the role of surgery, radiotherapy (RT) and chemotherapy in the management of recurrent LGG. There is increasing evidence to support maximal EOR for treating recurrent LGG, as it may improve progression free survival (PFS) after recurrence and overall survival (OS). Based on the studies presented in this review, we suggest that repeat surgery with maximal EOR should be standard of care for recurrent LGG treatment.