Extent of resection and molecular pathologic subtype are potent prognostic factors of adult WHO grade II glioma
Extent of resection and molecular pathologic subtype are potent prognostic factors of adult WHO grade II glioma
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DOI：
10.1038/s41598-020-59089-x
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发表时间：
2020-02-07
影响因子：
4.6
通讯作者：
Suh, Chang-Ok
中科院分区：
文献类型：
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作者：
Choi, Jinhyun;Kim, Se Hoon;Suh, Chang-Ok
我们根据2016年WHO新分类评估了成人低级别胶质瘤（LGG）的预后因素。回顾性分析了2003年至2015年期间诊断为WHO II级LGG的153例患者的记录。根据2016年WHO分类，80例患者（52.3%）患有弥漫性星形细胞瘤，IDH突变型; 45例（29.4%）患有少突胶质细胞瘤，IDH突变型和1 p/19 q共缺失（ODG）; 28例（18.3%）患有弥漫性星形细胞瘤，IDH野生型。71例患者（46.4%）进行了大体全切除（GTR），31例（20.3%）进行了次全切除，43例（28.1%）进行了部分切除，8例（5.2%）进行了活检。术后放疗102例（66.7%）。5年和10年无进展生存率（PFS）分别为72.7%和51.5%，5年和10年总生存率（OS）分别为82.5%和63.5%。GTR和IDH突变和/或1 p/19 q共缺失是PFS和OS的有利预后因素。IDH野生型患者的OS显著降低。在接受GTR的ODG患者中，放疗后未观察到复发。接受非GTR的患者在放疗后经常复发（IDH突变型：47.6%，IDH野生型：57.9%）。总之，LGG的分子分类与预后相关，IDH野生型患者的预后特别差，无论治疗如何。在接受GTR的患者中观察到了有利的结果。
We evaluated prognostic factors of adult low-grade glioma (LGG) according to the new 2016 WHO classification. Records of 153 patients diagnosed with WHO grade II LGG between 2003 and 2015 were retrospectively reviewed. Based on the 2016 WHO classification, 80 patients (52.3%) had diffuse astrocytoma, IDH-mutant; 45 (29.4%) had oligodendroglioma, IDH-mutant and 1p/19q-codeleted (ODG); and 28 (18.3%) had diffuse astrocytoma, IDH-wildtype. Gross total resection (GTR) was performed in 71 patients (46.4%), subtotal resection in 31 (20.3%), partial resection in 43 (28.1%), and biopsy in 8 (5.2%). One hundred two patients (66.7%) received postoperative radiotherapy. The 5- and 10-year progression-free survival (PFS) rates were 72.7% and 51.5%, respectively, and the 5- and 10-year overall survival (OS) rates were 82.5% and 63.5%, respectively. GTR and IDH-mutant and/or 1p/19q codeletion were favorable prognostic factors for PFS and OS. Patients with IDH-wildtype had significantly decreased OS. Among patients with ODG who underwent GTR, no recurrence was observed after radiotherapy. Patients who underwent non-GTR frequently experienced recurrence after radiotherapy (IDH-mutant: 47.6%, IDH-wildtype: 57.9%). In conclusion, molecular classification of LGG was of prognostic relevance, with IDH-wildtype patients having a particularly poor outcome, regardless of the treatment. Favorable results were observed in patients who underwent GTR.