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October 1990

Low-Grade Gliomas: To Treat or Not to Treat? A Consensus Challenged

Arch Neurol. 1990;47(10):1140. doi:10.1001/archneur.1990.00530100110025

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When I first invited a controversy on the management of low-grade glioma, I had difficulty finding two contributors who would argue contrary views. The two individuals who finally agreed to address the issue discussed it with each other and coauthored a consensus.

Declaring a consensus invites its overthrow. Although Shaw's arguments do not rebut the position argued and reaffirmed by Cairncross and Laperriere, his arguments do provide a rationale for a more aggressive approach.

Where there is uncertainty about the outcome, controlled studies are justified. Probably all contributors would agree on the need to test their respective approaches prospectively. In this we may have reached yet another consensus, subject to further controversy.—

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