Low-grade glioma with transformation to anaplastic (grade 3) or glioblastoma (grade 4): n...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-GLIOMA-LOW-GRADE-TRANSFORMATION-PROGRESSION`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-GLIOMA-LOW-GRADE`
Sources	`SRC-EANO-GBM-2024` `SRC-NCCN-CNS-2025`

Red Flag Origin

Definition	Low-grade glioma with transformation to anaplastic (grade 3) or glioblastoma (grade 4): new contrast-enhancing lesion, rapid growth on MRI, new neurological deficit, biopsy showing higher-grade features
Clinical direction	intensify
Category	transformation-progression
Shifts algorithm	ALGO-GLIOMA-LGG-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "new_contrast_enhancement_mri",
      "value": true
    },
    {
      "finding": "rapid_volume_growth_mri",
      "value": true
    },
    {
      "finding": "biopsy_higher_grade_features",
      "value": true
    },
    {
      "finding": "new_focal_neurologic_deficit",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

Transformation rate of LGG to higher grade: ~50-70% over 5-10 years. Per EANO 2024 + NCCN-CNS: transformation triggers re-resection + re-biopsy, then GBM-like Stupp protocol (RT + concurrent and adjuvant TMZ); IDH-mut transformed glioma still has slightly better OS than de novo IDH-wt GBM but managed similarly. Direction INTENSIFY — shifts to GBM algorithm. STUB — requires clinical co-lead signoff.

Used By

No reverse references found in the YAML corpus.