When do you refer a patient with recurrent glioma for reoperation?

This question is a nuanced one that is dependent on many factors. When a patient has a recurrent glioma, the treatment options are generally re-resection, medical therapy (traditional chemotherapy or targeted agents, depending on the tumor), or radiation. Which treatment modality, or combination of treatments, depends on a number of considerations. Some key considerations include:

1. Where is the tumor located, and is it feasible to achieve a complete or extensive resection with surgery? If complete resection is possible and safe, this is often the first choice of treatment and may give the best chance of cure or improved outcomes. If a complete resection cannot be achieved, partial resections often still improve survival, but the decision on...