Oligodendroglioma Surgery and Treatment Options

What Is Oligodendroglioma Surgery?

Oligodendroglioma surgery removes as much of this slow-growing brain tumor as the surgeon can take out safely. It also provides the tissue for the gene tests that confirm the diagnosis. For most people, it forms the first step of treatment.

An oligodendroglioma grows from cells that resemble oligodendrocytes, the cells that insulate nerve fibers. It belongs to the glioma family and mostly sits in the outer layer of the brain, often the frontal lobe. Our overview of brain tumor treatment also covers other types.

Two gene changes define it: an IDH mutation and the loss of parts of chromosomes 1 and 19, called the 1p/19q codeletion. So this tumor often responds well to treatment, and many people live with it for many years.

At a Glance

• What it isA diffuse glioma with an IDH mutation and a 1p/19q codeletion
• GradesWHO grade 2 (slow) or grade 3 (faster, also called anaplastic)
• First signMost often a seizure; sometimes headaches or slow changes in thinking
• First treatmentSurgery to remove as much tumor as is safe, if possible
• After surgeryMRI checks, a targeted pill, or radiotherapy with PCV chemotherapy
• Follow-upRegular MRI scans for many years, often for life

Where Are You in Your Decision?

First, pick the line closest to your situation. It then takes you to the matching part of this guide.

1. 01A first seizure, and the MRI shows a tumorSigns and what the scan suggests→
2. 02A report that says IDH-mutant, 1p/19q-codeletedWhat grade 2 and grade 3 mean→
3. 03Unsure whether to operate now or waitSurgery, watching and biopsy compared→
4. 04A tumor close to speech or movement areasHow mapping and awake surgery protect function→
5. 05Surgery is done: radiotherapy, PCV or a pill?Treatment after surgery by grade→
6. 06The tumor has grown backOptions for a recurrent oligodendroglioma→
7. 07Planning surgery from abroadLength of stay, flights and care back home→

Oligodendroglioma Symptoms

According to NCI, a seizure forms the most common sign of an oligodendroglioma. Other symptoms depend on where the tumor sits. Because it grows slowly, signs can build over years.

Questions at this stage

When to See a Doctor

Most oligodendroglioma symptoms develop slowly, so you usually have time to book a visit. Some signs, however, call for emergency care.

These signs can mean bleeding or rising pressure in the skull. So go to the nearest emergency department first, rather than waiting for a visit abroad.

How Doctors Confirm an Oligodendroglioma

An MRI with contrast shows the tumor, but only tissue tests confirm the type. Since 2021, the WHO system requires both an IDH mutation and a 1p/19q codeletion for this name.

So the tissue from surgery or a biopsy goes to a neuropathologist. NICE also advises gene tests on every glioma, alongside the microscope. Many reports add TERT and MGMT results, too.

Oligodendroglioma Versus Astrocytoma

Both tumors carry an IDH mutation, but only an oligodendroglioma has the 1p/19q codeletion. That difference changes the chemotherapy plan and the outlook. If your report says astrocytoma instead, see our astrocytoma guide.

Oligodendroglioma Treatment Options Compared

Treatment depends on the grade, the size and site of the tumor, your age and how much tumor remains after surgery. A tumor board then weighs these factors together.

At this board, Prof. Albayrak reviews each case with radiation oncology, medical oncology, neuroradiology and neuropathology colleagues.

Oligodendroglioma Surgery: Maximal Safe Resection

The goal of surgery has two sides: remove as much tumor as possible and keep speech, movement and sensation intact. Prof. Albayrak treats this balance as the core of every glioma operation.

The usual operation, a craniotomy, opens a small window in the skull under anesthesia. Afterward, the bone goes back in place. Most operations take several hours.

Operate Now or Watch First?

Some small grade 2 tumors cause few symptoms, so waiting can seem tempting. However, a scan alone cannot confirm the grade or the gene profile. So many teams now favor early surgery when the tumor can come out safely.

Watching with MRI may still suit a few people, for instance when surgery carries high risk. In that case, ask how often scans will follow and which change would prompt surgery.

Tools That Help Protect Brain Function

Prof. Albayrak uses these methods, chosen for each tumor:

• Microsurgery: work under a high-power microscope, millimeter by millimeter
• Neuronavigation: a 3D map from your MRI that guides the route
• Neuromonitoring: live checks of movement and speech pathways during removal
• Fluorescence guidance: a dye that helps show tumor tissue under special light

His 2004 review in Acta Neurochirurgica also describes MRI scans during surgery. Such scans help especially with low-grade gliomas, whose edges look like normal brain.

Awake Surgery Near Speech and Movement Areas

Oligodendrogliomas often reach into the cortex, close to speech or movement areas. In an awake craniotomy, you wake during the mapping stage. The team then tests your speech and movement while the surgeon works.

The brain itself feels no pain, and the team stays with you throughout. Awake surgery also suits many insular gliomas.

When a Biopsy Comes First

Sometimes the tumor lies too deep or spreads too widely for safe removal. A stereotactic biopsy then takes a small sample through a tiny hole. That sample still allows the full gene tests.

Risks of Oligodendroglioma Surgery

Every brain operation carries real risks. Most serious problems stay uncommon, but you should know them before you decide.

• New weakness, numbness or speech trouble, often temporary
• Seizures in the first days
• Brain swelling, usually eased with steroid medicine
• Bleeding in the brain
• Infection of the wound or the brain lining
• Blood clots in the legs or lungs

Your own risk depends on the tumor's size and position, and on your health. So ask which risks matter most in your case.

Treatment After Oligodendroglioma Surgery

The plan after surgery follows the grade, your age and any tumor left on the MRI. NICE gives clear thresholds, and your team then adapts them to you.

Grade 2: Three Main Paths

For grade 2, NICE advises radiotherapy followed by up to 6 cycles of PCV for people aged about 40 or over, or with tumor left on the MRI. Younger people with a full removal, in contrast, may start with MRI checks alone.

In 2024, the FDA also approved vorasidenib for grade 2 oligodendroglioma after surgery. This daily pill blocks the faulty IDH enzyme and so can delay radiotherapy. Your oncologist then checks whether it suits you.

Grade 3: Radiotherapy and PCV

For grade 3, NICE advises radiotherapy and 4 to 6 cycles of PCV chemotherapy. PCV combines three drugs: procarbazine, lomustine and vincristine. The order of the two treatments follows a talk with you about side effects.

Temozolomide, a capsule chemotherapy, also appears in some plans. However, NCI notes that trials still test its role in oligodendroglioma.

Recovery and Follow-Up After Oligodendroglioma Surgery

Recovery usually starts with a night or two in intensive care, then several days on the ward. Most people walk with help on the first day. The final plan, however, waits for the gene results.

A Typical Timeline

How Often You Need MRI Scans

For grade 2 and grade 3 oligodendroglioma, NICE suggests this schedule. Your own team may then adapt it:

• Years 0-2: a scan at 3 months, then every 6 months
• Years 2-4: once a year
• Years 5-10: every 1 to 2 years
• After 10 years: consider a scan every 1 to 2 years for life

Living With an Oligodendroglioma

Tiredness often lasts for months, especially after radiotherapy. Physiotherapy, speech therapy and occupational therapy also help many people regain skills.

UK drivers must tell the DVLA and usually stop driving for a period after surgery. The length depends on the grade and on seizures, so check local rules elsewhere.

When an Oligodendroglioma Comes Back

An oligodendroglioma often regrows after some years, because cells stay behind in the brain. Regular MRI scans usually catch it early, before new symptoms appear.

Options then include a second operation, radiotherapy, chemotherapy or a clinical trial. Repeat surgery suits a regrowth that lies in a safe spot, and it also gives fresh tissue to check the grade. Our recurrent glioma surgery guide explains how teams tell regrowth from radiation changes.

What Shapes the Outlook

According to NCI, this tumor has one of the more favorable outlooks among gliomas. Still, no single number fits everyone. Grade, age, leftover tumor and general health all play a part.

For grade 3 tumors and glioblastoma, see our guide to brain cancer and its surgical treatment. Ask your own team for an estimate, rather than relying on online averages.

Coming to Istanbul from the US, Canada, the UK or Europe

Oligodendroglioma care has two parts: surgery, then often months of scans, radiotherapy or chemotherapy. So many people have surgery in Istanbul and continue further treatment at home.

How Long to Stay in Istanbul

First, add up the consultation, any new scans, the operation and the hospital stay. Then rest near the hospital until your wound check. Overall, many plans come to about two weeks in Istanbul.

When You Can Fly Home

UK aviation guidance advises waiting about 7 days after brain surgery before flying. Air left inside the skull can expand at altitude. The US CDC also warns that flying soon after surgery raises the risk of blood clots.

Treatment and Follow-Up at Home

Before you leave, ask for the discharge summary, the full pathology report and copies of all scans. Your home team may also ask for the tissue blocks to repeat the gene tests. So book your oncology visit early, because treatment often starts within weeks.

For insurance and Medicare, see brain surgery in Turkey: planning from the US. For NHS rules and travel insurance, see planning from the UK. From Canada, check with your provincial health plan and private insurer before you book.

Your Oligodendroglioma Surgeon in Istanbul

Prof. Dr. Serdar Baki Albayrak

Neurosurgeon · Full Professor of Neurosurgery

An oligodendroglioma often touches the cortex near speech or movement areas, so each millimeter counts. For this reason, Prof. Albayrak combines microsurgery with navigation, nerve monitoring and, where useful, awake mapping.

He completed his neurosurgery training at Istanbul University in 2004. He then took clinical fellowships at the University of Helsinki and Harvard Medical School. At Harvard, he trained at Brigham and Women's Hospital.

27+Years

5,000+Operations

64Countries

33Publications

Figures from Prof. Albayrak's professional profile, September 2026. See his full publication list.

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