1. Differences in the Prognostic Role of Age, Extent of Resection, and Tumor Grade between Astrocytoma IDHmt and Oligodendroglioma: A Single-Center Cohort Study.
- Author
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van der Vaart T, Wijnenga MMJ, van Garderen K, Dubbink HJ, French PJ, Smits M, Dirven CMF, Kros JM, Vincent AJPE, and van den Bent MJ
- Subjects
- Humans, Female, Male, Middle Aged, Prognosis, Adult, Retrospective Studies, Aged, Age Factors, Magnetic Resonance Imaging methods, Tumor Burden, Oligodendroglioma genetics, Oligodendroglioma pathology, Oligodendroglioma surgery, Oligodendroglioma mortality, Astrocytoma pathology, Astrocytoma genetics, Astrocytoma surgery, Astrocytoma mortality, Astrocytoma diagnostic imaging, Isocitrate Dehydrogenase genetics, Neoplasm Grading, Mutation, Brain Neoplasms pathology, Brain Neoplasms surgery, Brain Neoplasms mortality, Brain Neoplasms genetics, Brain Neoplasms diagnostic imaging, Brain Neoplasms diagnosis
- Abstract
Purpose: IDH-mutant glioma is classified as oligodendroglioma or astrocytoma based on 1p19q-codeletion. Whether prognostic factors are similar between these tumor types is not well understood., Experimental Design: Retrospective cohort study. Molecular characterization was performed with targeted next-generation sequencing. Tumor volumes were calculated using semiautomatic 3D segmentation on all pre- and post-operative MRI scans. Overall survival was assessed with the Cox-proportional hazards model., Results: A total of 383 patients with newly diagnosed IDH-mutant glioma were followed up for a median of 7.2 years. Grades 3 and 4 patients had significantly lower Karnofsky performance, with tumors having more contrast enhancement. Patients also received more aggressive postsurgery treatment. Postoperative tumor volume is significantly and independently associated with survival (HR, per cm3 1.19; 95% CI, 1.03-1.39) in IDH-mutant glioma. A separate analysis of oligodendroglioma and astrocytoma showed a significant association of postoperative tumor volume in astrocytoma but not in oligodendroglioma. Higher age and histologic tumor grade were associated with worse survival in patients with oligodendroglioma but not with astrocytoma., Conclusions: Our data support an initial strategy of extensive resection in patients with oligodendroglioma and astrocytoma. Other important prognostic factors differ between these tumor types, urging researchers and clinicians to keep treating these tumors as separate entities., (©2024 American Association for Cancer Research.)
- Published
- 2024
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