From expert opinion to evidence-based: changes in the gold standard of primary brain tumour diagnosis.

Since 1997, significant progress has been made in the WHO guidelines for the diagnosis of primary tumours of the central nervous system. A large group of international experts was involved in editing the content; consensus on definitions and classifications was sought; and updated findings of genomic investigations were included. Nevertheless, significant inter-observer variability still exists in the histopathological diagnosis of several tumour types. The challenge for the near future is to identify histological and genotypic characteristics with prognostic or predictive value. With that aim, testing histological or molecular parameters in prospective clinical studies is indicated.