2024 Volume 33 Issue 2 Pages 90-95
The 2021 World Health Organization Classification of Tumours of the Central Nervous System (WHO2021) is a fully integrated molecular classification system for diagnosing glial tumors. This revision was a major upgrade from the previous edition (the WHO2016). The WHO2021 now not only requires detailed molecular characterization of the tumor but also drastically changes the philosophy of tumor grading from “across the tumor entity” to “within tumor types.” These changes greatly impact how clinicians should build treatment strategies for individual patients with astrocytoma and oligodendroglioma, as most evidence is based on clinical trials designed during the pre-molecular era. This review aims to clarify the current consensus regarding diagnosis, the role of surgery, and adjuvant therapy for astrocytoma and oligodendroglioma. Controversial and unsolved issues are also discussed. Ultimately, the article will discuss the uncharted territory of using molecular targeting drugs for this malignancy.