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In one center early resection was favored; in the other center an early biopsy and wait-and-scan approach was the dominant management. In addition, the authors present survival and health-related quality of life (HRQOL) in stratified groups of patients with <jats:italic>IDH<\/jats:italic>-mutant astrocytoma and oligodendroglioma.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors conducted a retrospective, population-based, parallel cohort study with extended long-term follow-up. The inclusion criteria were histopathological diagnosis of <jats:italic>IDH<\/jats:italic>-mutant supratentorial dLGG from 1998 through 2009 in patients aged 18 years or older. Follow-up ended January 1, 2021; therefore, all patients had primary surgery more than 10 years earlier. In region A, a biopsy and wait-and-scan approach was favored, while early resections were advocated in region B. Regional referral practice ensured population-based data, since referral to respective centers was based strictly on the patient\u2019s residential address. Previous data from EQ-5D-3L, European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, and EORTC BN20 questionnaires were reanalyzed with respect to the current selection of <jats:italic>IDH<\/jats:italic>-mutant dLGG and to molecular subgroups. The prespecified primary endpoint was long-term regional comparison of overall survival. Secondarily, between-group differences in long-term HRQOL measures were explored.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Forty-eight patients from region A and 56 patients from region B were included. Early resection was performed in 17 patients (35.4%) from region A compared with 53 patients (94.6%) from region B (p &lt; 0.001). Characteristics at baseline were otherwise similar between cohorts. Overall survival was 7.5 years (95% CI 4.1\u201310.8) in region A compared with 14.6 years (95% CI 11.5\u201317.7) in region B (p = 0.04). When stratified according to molecular subgroups, there was only a statistically significant survival benefit in favor of early resection for patients with astrocytomas. The were no apparent differences in the different HRQOL measures between cohorts.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In an extended follow-up of patients with <jats:italic>IDH<\/jats:italic>-mutant dLGGs, early resection was associated with a sustained and clinically relevant survival benefit. The survival benefit was not counteracted by any detectable reduction in HRQOL.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.1.jns212514","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T08:06:40Z","timestamp":1646381200000},"page":"1321-1328","source":"Crossref","is-referenced-by-count":31,"title":["The impact of resection in IDH-mutant WHO grade 2 gliomas: a retrospective population-based parallel cohort study"],"prefix":"10.3171","volume":"137","author":[{"given":"Asgeir S.","family":"Jakola","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, St. Olav\u2019s University Hospital, Trondheim, Norway;"},{"name":"Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden;"},{"name":"Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Kjelsberg","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Northern Norway, Troms\u00f8, Norway;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne J.","family":"Skjulsvik","sequence":"additional","affiliation":[{"name":"Department of Pathology, St. Olav\u2019s University Hospital, Trondheim, Norway;"},{"name":"Department of Laboratory Medicine, Children\u2019s and Women\u2019s Health, Norwegian University of Science and Technology, Trondheim, Norway;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Myrmel","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, University Hospital of Northern Norway, Troms\u00f8, Norway; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Sj\u00e5vik","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Northern Norway, Troms\u00f8, Norway;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole","family":"Solheim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, St. Olav\u2019s University Hospital, Trondheim, Norway;"},{"name":"Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"b1","series-title":"Neuro Oncol","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","article-title":"The 2021 WHO Classification of Tumors of the Central Nervous System: a summary","volume":"23","author":"Louis DN","year":"2021","unstructured":"Louis DN, Perry A, Wesseling P,  The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. 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