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Yet, surgical radicality must be balanced against the risks of complications that may affect long\u2010term quality of life. We investigated whether this consideration impacted surgical resection patterns over time for patients of the German LGG studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Four thousand two hundred and seventy pediatric patients from three successive LGG studies (median age at diagnosis 7.6\u2009years, neurofibromatosis (NF1) 14.7%) were grouped into 5 consecutive time intervals (TI1\u20105) for date of diagnosis and analyzed for timing and extent of first surgery with respect to tumor site, histology, NF1\u2010status, sex, and age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The fraction of radiological LGG diagnoses increased over time (TI1 12.6%; TI5 21.7%), while the extent of the first neurosurgical intervention (3440\/4270) showed a reduced fraction of complete\/subtotal and an increase of partial resections from TI1 to TI5. Binary logistic regression analysis for the first intervention within the first year following diagnosis confirmed the temporal trends (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and the link with tumor site for each extent of resection (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Higher age is related to more complete resections in the cerebellum and cerebral hemispheres.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The declining extent of surgical resections over time was unrelated to patient characteristics. It paralleled the evolution of comprehensive treatment algorithms; thus, it may reflect alignment of surgical practice to recommendations in respect to age, tumor site, and NF1\u2010status integrated as such into current treatment guidelines. Further investigations are needed to understand how planning, performance, or tumor characteristics impact achieving surgical goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.7417","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T05:59:53Z","timestamp":1719208793000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Adaption of neurosurgical resection patterns for pediatric low\u2010grade glioma spanning two decades\u2014Report from the German\n                    <scp>LGG<\/scp>\n                    \u2010studies 1996\u20132018"],"prefix":"10.1002","volume":"13","author":[{"given":"Tibor","family":"Kelety","sequence":"first","affiliation":[{"name":"Pediatrics and Adolescent Medicine, Swabian Children's Cancer Center University Hospital Augsburg  Augsburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich\u2010Wilhelm","family":"Thomale","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery, Campus Virchow Klinikum, Charit\u00e9 \u2013 Universitaetsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8631-868X","authenticated-orcid":false,"given":"Daniela","family":"Kandels","sequence":"additional","affiliation":[{"name":"Pediatrics and Adolescent Medicine, Swabian Children's Cancer Center University Hospital Augsburg  Augsburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin U.","family":"Schuhmann","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery University Hospital of Tuebingen, Eberhard Karls University  Tuebingen 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Hern\u00e1iz","family":"Driever","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology Charit\u00e9 \u2013 Universitaetsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olaf","family":"Witt","sequence":"additional","affiliation":[{"name":"Hopp Children's Cancer Center Heidelberg (KiTZ), Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ) Heidelberg University Hospital, National Center for Tumor Diseases (NCT)  Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"Bison","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Neuroradiology, Faculty of Medicine University of Augsburg  Augsburg 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