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A single-institution retrospective analysis of pathologically determined malignant transformation in IDH mutant glioma patients.
Liu, Vicki; Wetzel, Ethan A; Eldred, Blaine S C; Zapanta Rinonos, Serendipity; Prins, Terry J; Khanlou, Negar; Liau, Linda M; Chong, Robert; Nghiemphu, Phioanh L; Cloughesy, Timothy F; Ellingson, Benjamin M; Lai, Albert.
Afiliação
  • Liu V; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Wetzel EA; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Eldred BSC; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Zapanta Rinonos S; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Prins TJ; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Khanlou N; Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Liau LM; Department of Neurosurgery, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Chong R; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Nghiemphu PL; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Cloughesy TF; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Ellingson BM; Department of Radiological Sciences, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
  • Lai A; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
Neurooncol Adv ; 5(1): vdad036, 2023.
Article em En | MEDLINE | ID: mdl-37152809
Background: Lower-grade IDH mutant glioma patients frequently undergo malignant transformation (MT), with apparent worse prognosis. Many studies examine MT in mixed IDH status cohorts and define MT using imaging, not histopathology. Our study examines the timing, predictors, and prognostic implications of pathologically determined MT in a large, exclusively IDH mutant cohort. Methods: We identified 193 IDH mutant lower-grade glioma patients at UCLA who received multiple surgeries. We examined the outcomes of pathologically determined MT patients. Results: Time to MT is longer in grade 2 oligodendroglioma (G2 Oligo) than in grade 2 astrocytoma (G2 Astro) (HR = 0.46, P = .0007). The grade 3 astrocytoma (G3 Astro) to grade 4 astrocytoma (G4 Astro) interval is shorter in stepwise MT (G2 to G3 to G4 Astro) patients than in initial G3 Astro patients (P = .03). Novel contrast enhancement had 65% positive predictivity, 67% negative predictivity, 75% sensitivity, and 55% specificity in indicating pathologically defined MT. In G2 Astro, initial gross total resection delayed MT (HR = 0.50, P = .02) and predicted better overall survival (OS) (HR = 0.34, P = .009). In G2 Oligo, spontaneous MT occurred earlier than treated MT (HR = 11.43, P = .0002), but treatment did not predict improved OS (P = .8). MT patients (n = 126) exhibited worse OS than non-MT patients (n = 67) in All (HR = 2.54, P = .0009) and G2 Astro (HR = 4.26, P = .02). Conclusion: Our study expands the understanding of MT to improve IDH mutant lower-grade glioma management.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2023 Tipo de documento: Article
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2023 Tipo de documento: Article