Pilocytic astrocytoma is a CNS WHO grade 1 tumor. In adult patients aged 18 years or older, the therapeutic focus is on achieving durable local tumor control — and, when seizures are present, freedom from seizures.
This protocol applies specifically to patients aged 18 years or older with a diagnosis of pilocytic astrocytoma.
Management centres on a surgical strategy that prioritises the most complete tumor removal the anatomy will allow, with the extent of resection directly influencing long-term outcomes. The full protocol — including the complete decision algorithm and all clinical considerations — is accessible below.
DOI: 10.1093/neuonc/noac188
Gross total resection, when feasible, is the most important treatment in terms of prolonging survival and achieving long-term seizure control.
Resection is recommended to obtain a histological and molecular diagnosis and should be a gross total resection whenever feasible.
Gross total resection for well-circumscribed CNS WHO grade 1 tumors can produce long-term tumor control and even cure.
Early operative intervention and gross-total resection are critically important factors in achieving seizure-freedom and should be proposed in patients presenting with seizures.
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