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Cao J, Yan W, Zhan Z, Hong X, Yan H. Epidemiology and risk stratification of low-grade gliomas in the United States, 2004-2019: A competing-risk regression model for survival analysis. Front Oncol 2023; 13:1079597. [PMID: 36937393 PMCID: PMC10014976 DOI: 10.3389/fonc.2023.1079597] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/13/2023] [Indexed: 03/04/2023] Open
Abstract
Background Understanding the epidemiology and prognostic factors of low-grade gliomas (LGGs) can help estimate the public health impact and optimize risk stratification and treatment strategies. Methods 3 337 patients diagnosed with LGGs were collected from the Surveillance, Epidemiology, and End Results (SEER) dataset, 2004-2019. The incidence trends of LGGs were analyzed by patient demographics (sex, age, race, and ethnicity). In addition, a competing risk regression model was used to explore the prognostic factors of LGGs by patient demographics, tumor characteristics (histological subtypes, invasiveness, and size), treatment modality, and molecular markers (IDH mutation and 1p/19q codeletion). Results LGGs occurred more frequently in male, non-Hispanic, and White populations. The incidence rate of mixed gliomas was stable from 2004 to 2013 and decreased dramatically to nearly zero until 2019. The risk of death increased 1.99 times for every 20-year increase in patient age, and 60 years is a predictive cut-off age for risk stratification of LGGs. Male patients showed poorer LGG-specific survival. Among the different subtypes, astrocytoma has the worst prognosis, followed by mixed glioma and oligodendroglioma. Tumors with larger size (≥5 cm) and invasive behavior tended to have poorer survival. Patients who underwent gross total resection had better survival rates than those who underwent subtotal resection. Among the different treatment modalities, surgery alone had the best survival, followed by surgery + radiotherapy + chemotherapy, but chemotherapy alone had a higher death risk than no treatment. Furthermore, age, invasiveness, and molecular markers were the most robust prognostic factors. Conclusion This study reviewed the incidence trends and identified several prognostic factors that help clinicians identify high-risk patients and determine the need for postoperative treatment according to guidelines.
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Affiliation(s)
- Junguo Cao
- Shaanxi Eye Hospital (Xi’an People’s Hospital), Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University; Affiliated Guangren Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Division of Experimental Neurosurgery, Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - Weijia Yan
- Shaanxi Eye Hospital (Xi’an People’s Hospital), Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University; Affiliated Guangren Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Zhixin Zhan
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
| | - Xinyu Hong
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Hong Yan, ; Xinyu Hong,
| | - Hong Yan
- Shaanxi Eye Hospital (Xi’an People’s Hospital), Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University; Affiliated Guangren Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- *Correspondence: Hong Yan, ; Xinyu Hong,
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Feraco P, Franciosi R, Picori L, Scalorbi F, Gagliardo C. Conventional MRI-Derived Biomarkers of Adult-Type Diffuse Glioma Molecular Subtypes: A Comprehensive Review. Biomedicines 2022; 10:biomedicines10102490. [PMID: 36289752 PMCID: PMC9598857 DOI: 10.3390/biomedicines10102490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/28/2022] [Accepted: 10/02/2022] [Indexed: 11/25/2022] Open
Abstract
The introduction of molecular criteria into the classification of diffuse gliomas has added interesting practical implications to glioma management. This has created a new clinical need for correlating imaging characteristics with glioma genotypes, also known as radiogenomics or imaging genomics. Although many studies have primarily focused on the use of advanced magnetic resonance imaging (MRI) techniques for radiogenomics purposes, conventional MRI sequences remain the reference point in the study and characterization of brain tumors. A summary of the conventional imaging features of glioma molecular subtypes should be useful as a tool for daily diagnostic brain tumor management. Hence, this article aims to summarize the conventional MRI features of glioma molecular subtypes in light of the recent literature.
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Affiliation(s)
- Paola Feraco
- Neuroradiology Unit, Ospedale S. Chiara, Azienda Provinciale per i Servizi Sanitari, Largo Medaglie d’oro 9, 38122 Trento, Italy
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via S. Giacomo 14, 40138 Bologna, Italy
- Correspondence:
| | - Rossana Franciosi
- Radiology Unit, Santa Maria del Carmine Hospital, 38068 Rovereto, Italy
| | - Lorena Picori
- Nuclear Medicine Unit, Ospedale S. Chiara, Azienda Provinciale per i Servizi Sanitari, Largo Medaglie d’oro 9, 38122 Trento, Italy
| | - Federica Scalorbi
- Nuclear Medicine Unit, Foundation IRCSS, Istituto Nazionale dei Tumori, 20121 Milan, Italy
| | - Cesare Gagliardo
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
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Merenzon MA, Gómez Escalante JI, Prost D, Seoane E, Mazzon A, Bilbao ÉR. Preoperative imaging features: Are they useful tools for predicting IDH1 mutation status in gliomas Grades II–IV? Surg Neurol Int 2022; 13:332. [PMID: 36128131 PMCID: PMC9479512 DOI: 10.25259/sni_373_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background: It is already known that gliomas biomolecular parameters have a reliable prognostic value. However, an invasive procedure is required to determine them. Our aim was to better understand the clinical characteristics of gliomas Grades II–IV and to assess the usefulness of imaging features in magnetic resonance imaging (MRI) to predict the isocitrate dehydrogenase one (IDH1) mutation. Methods: Preoperative MRI characteristics were retrospectively reviewed and molecular diagnosis of gliomas was tested in adult patients between 2014 and 2021 in two institutions. We applied a biological criterion to divide the brain in cerebral compartments. Results: A total of 108 patients met the inclusion criteria. Contrast enhancement (CE) in MRI was significantly associated with wild-type IDH1 (IDH1-Wt) (P < 0.00002). Furthermore, the positive predictive value of CE for IDH1-Wt was of 87.1%. On the other hand, the negative predictive value of non-CE for mutated IDH1 (IDH1-Mut) was of 52.6%; 60.2% of gliomas were located in the neocortical and 24.1% in the allocortical/mesocortical telencephalon. Considering gliomas Grades II–III, 66.7% of IDH1-Mut and 28.6% of IDH1-Wt gliomas were located in the neocortex, without statistical significance. Conclusion: Our research revealed that CE is useful for predicting IDH1-Wt in gliomas. On the contrary, nonCE is not useful for predicting IDH1-Mut gliomas. Thus, the traditional concept of associating non-CE MRI with a low-grade glioma should be reviewed, as it can lead to an underestimation of the potential aggressiveness of the tumor. If this association was validated with the future prospective studies, a noninvasive tool would be available for predicting gliomas IDH1 mutation status.
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Affiliation(s)
| | | | - Diego Prost
- Department of Neuro-Oncology, Oncology, Instituto de Oncología Ángel H Roffo,
| | - Eduardo Seoane
- Department of Neurosurgery, “José María Ramos Mejía” General Hospital, Buenos Aires, Argentina
| | - Alejandro Mazzon
- Department of Neurosurgery, Instituto de Oncología Ángel H Roffo,
| | - Érica Rojas Bilbao
- Department of Diagnosis, Pathology, Instituto de Oncología Ángel H Roffo,
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Girard A, Le Reste PJ, Metais A, Carsin Nicol B, Chiforeanu DC, Bannier E, Campillo-Gimenez B, Devillers A, Palard-Novello X, Le Jeune F. Combining 18F-DOPA PET and MRI with perfusion-weighted imaging improves delineation of high-grade subregions in enhancing and non-enhancing gliomas prior treatment: a biopsy-controlled study. J Neurooncol 2021; 155:287-295. [PMID: 34686993 DOI: 10.1007/s11060-021-03873-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE We aimed to compare spatial extent of high-grade subregions detected with combined [18F]-dihydroxyphenylalanine (18F-DOPA) PET and MRI to the one provided by advanced multimodal MRI alone including Contrast-enhanced (CE) and Perfusion weighted imaging (PWI). Then, we compared the accuracy between imaging modalities, in a per biopsy analysis. METHODS Participants with suspected diffuse glioma were prospectively included between June 2018 and September 2019. Volumes of high-grade subregions were delineated respectively on 18F-DOPA PET and MRI (CE and PWI). Up to three per-surgical neuronavigation-guided biopsies were performed per patient. RESULTS Thirty-eight biopsy samples from sixteen participants were analyzed. Six participants (38%) had grade IV IDH wild-type glioblastoma, six (38%) had grade III IDH-mutated astrocytoma and four (24%) had grade II IDH-mutated gliomas. Three patients had intratumoral heterogeneity with coexisting high- and low-grade tumor subregions. High-grade volumes determined with combined 18F-DOPA PET/MRI (median of 1.7 [interquartile range (IQR) 0.0, 19.1] mL) were larger than with multimodal MRI alone (median 1.3 [IQR 0.0, 12.8] mL) with low overlap (median Dice's coefficient 0.24 [IQR 0.08, 0.59]). Delineation volumes were substantially increased in five (31%) patients. In a per biopsy analysis, combined 18F-DOPA PET/MRI detected high-grade subregions with an accuracy of 58% compared to 42% (p = 0.03) with CE MRI alone and 50% (p = 0.25) using multimodal MRI (CE + PWI). CONCLUSIONS The addition of 18F-DOPA PET to multimodal MRI (CE and PWI) enlarged the delineation volumes and enhanced overall accuracy for detection of high-grade subregions. Thus, combining 18F-DOPA with advanced MRI may improve treatment planning in newly diagnosed gliomas.
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Affiliation(s)
- Antoine Girard
- Department of Nuclear Medicine, Eugène Marquis Center, Avenue de la Bataille Flandres-Dunkerque, 35000, Rennes, France.
- Signal and Image Processing Laboratory (LTSI), INSERM-University of Rennes 1, Rennes, France.
| | | | - Alice Metais
- Department of Pathology, Rennes University Hospital, Rennes, France
| | | | | | - Elise Bannier
- Department of Radiology, Rennes University Hospital, Rennes, France
- Empenn IRISA Research Team, Rennes University-CNRS-INRIA-INSERM, Rennes, France
| | - Boris Campillo-Gimenez
- Department of Medical Oncology, Eugène Marquis Center, Rennes, France
- Signal and Image Processing Laboratory (LTSI), INSERM-University of Rennes 1, Rennes, France
| | - Anne Devillers
- Department of Nuclear Medicine, Eugène Marquis Center, Avenue de la Bataille Flandres-Dunkerque, 35000, Rennes, France
| | - Xavier Palard-Novello
- Department of Nuclear Medicine, Eugène Marquis Center, Avenue de la Bataille Flandres-Dunkerque, 35000, Rennes, France
- Signal and Image Processing Laboratory (LTSI), INSERM-University of Rennes 1, Rennes, France
| | - Florence Le Jeune
- Department of Nuclear Medicine, Eugène Marquis Center, Avenue de la Bataille Flandres-Dunkerque, 35000, Rennes, France
- Signal and Image Processing Laboratory (LTSI), INSERM-University of Rennes 1, Rennes, France
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Girard A, Le Reste PJ, Metais A, Chaboub N, Devillers A, Saint-Jalmes H, Jeune FL, Palard-Novello X. Additive Value of Dynamic FDOPA PET/CT for Glioma Grading. Front Med (Lausanne) 2021; 8:705996. [PMID: 34307430 PMCID: PMC8299331 DOI: 10.3389/fmed.2021.705996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose: The aim of this study was to assess the value of the FDOPA PET kinetic parameters extracted using full kinetic analysis for tumor grading with neuronavigation-guided biopsies as reference in patients with newly-diagnosed gliomas. Methods: Fourteen patients with untreated gliomas were investigated. Twenty minutes of dynamic positron-emission tomography (PET) imaging and a 20-min static image 10 min after injection were reconstructed from a 40-min list-mode acquisition immediately after FDOPA injection. Tumors volume-of-interest (VOI) were generated based on the MRI-guided brain biopsies. Static parameters (TBRmax and TBRmean) and kinetic parameters [K1 and k2 using full kinetic analysis with the reversible single-tissue compartment model with blood volume parameter and the time-to-peak (TTP)] were extracted. Performances of each parameter for differentiating low-grade gliomas (LGG) from high-grade gliomas (HGG) were evaluated by receiver-operating characteristic analyses (area under the curve; AUC). Results: Thirty-two tumoral VOI were analyzed. K1, k2, and TTP were significantly higher for HGG than for LGG (median K1-value = 0.124 vs. 0.074 ml/ccm/min, p = 0.025, median k2-value = 0.093 vs. 0.063 min−1, p = 0.025, and median TTP-value = 10.0 vs. 15.0 min, p = 0.025). No significant difference was observed for the static parameters. The AUC for the kinetic parameters was higher than the AUC for the static parameters (respectively, AUCK1 = 0.787, AUCk2 = 0.785, AUCTTP = 0.775, AUCTBRmax = 0.551, AUCTBRmean = 0.575), significantly compared to TBRmax (respectively, p = 0.001 for K1, p = 0.031 for k2, and p = 0.029 for TTP). Conclusion: The present study suggests an additive value of FDOPA PET/CT kinetic parameters for newly-diagnosed gliomas grading.
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Affiliation(s)
- Antoine Girard
- Univ Rennes, CLCC Eugène Marquis, Noyau Gris Centraux EA 4712, Rennes, France
| | | | | | - Nibras Chaboub
- Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI - UMR 1099, Rennes, France
| | - Anne Devillers
- Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI - UMR 1099, Rennes, France
| | - Hervé Saint-Jalmes
- Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI - UMR 1099, Rennes, France
| | - Florence Le Jeune
- Univ Rennes, CLCC Eugène Marquis, Noyau Gris Centraux EA 4712, Rennes, France
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Hosmann A, Millesi M, Wadiura LI, Kiesel B, Mercea PA, Mischkulnig M, Borkovec M, Furtner J, Roetzer T, Wolfsberger S, Phillips JJ, Berghoff AS, Hervey-Jumper S, Berger MS, Widhalm G. 5-ALA Fluorescence Is a Powerful Prognostic Marker during Surgery of Low-Grade Gliomas (WHO Grade II)-Experience at Two Specialized Centers. Cancers (Basel) 2021; 13:cancers13112540. [PMID: 34064222 PMCID: PMC8196836 DOI: 10.3390/cancers13112540] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022] Open
Abstract
The prediction of the individual prognosis of low-grade glioma (LGG) patients is limited in routine clinical practice. Nowadays, 5-aminolevulinic acid (5-ALA) fluorescence is primarily applied for improved intraoperative visualization of high-grade gliomas. However, visible fluorescence is also observed in rare cases despite LGG histopathology and might be an indicator for aggressive tumor behavior. The aim of this study was thus to investigate the value of intraoperative 5-ALA fluorescence for prognosis in LGG patients. We performed a retrospective analysis of patients with newly diagnosed histopathologically confirmed LGG and preoperative 5-ALA administration at two independent specialized centers. In this cohort, we correlated the visible intraoperative fluorescence status with progression-free survival (PFS), malignant transformation-free survival (MTFS) and overall survival (OS). Altogether, visible fluorescence was detected in 7 (12%) of 59 included patients in focal intratumoral areas. At a mean follow-up time of 5.3 ± 2.9 years, patients with fluorescing LGG had significantly shorter PFS (2.3 ± 0.7 vs. 5.0 ± 0.4 years; p = 0.01), MTFS (3.9 ± 0.7 vs. 8.0 ± 0.6 years; p = 0.03), and OS (5.4 ± 1.0 vs. 10.3 ± 0.5 years; p = 0.01) than non-fluorescing tumors. Our data indicate that visible 5-ALA fluorescence during surgery of pure LGG might be an already intraoperatively available marker of unfavorable patient outcome and thus close imaging follow-up might be considered.
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Affiliation(s)
- Arthur Hosmann
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Matthias Millesi
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Lisa I. Wadiura
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Barbara Kiesel
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Petra A. Mercea
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Mario Mischkulnig
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Martin Borkovec
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
| | - Julia Furtner
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
| | - Thomas Roetzer
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Wolfsberger
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Joanna J. Phillips
- Department of Pathology, University of California, San Francisco (UCSF), CA 94143, USA;
| | - Anna S. Berghoff
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
- Division of Oncology, Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Shawn Hervey-Jumper
- Department of Neurological Surgery, University of California, San Francisco (UCSF), CA 94143, USA; (S.H.-J.); (M.S.B.)
| | - Mitchel S. Berger
- Department of Neurological Surgery, University of California, San Francisco (UCSF), CA 94143, USA; (S.H.-J.); (M.S.B.)
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
- Correspondence: ; Tel.: +43-1-40400-45650
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Lin Z, Yang R, Li K, Yi G, Li Z, Guo J, Zhang Z, Junxiang P, Liu Y, Qi S, Huang G. Establishment of age group classification for risk stratification in glioma patients. BMC Neurol 2020; 20:310. [PMID: 32819307 PMCID: PMC7439690 DOI: 10.1186/s12883-020-01888-w] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/16/2020] [Indexed: 12/14/2022] Open
Abstract
Background Age is associated with the prognosis of glioma patients, but there is no uniform standard of age-group classification to evaluate the prognosis of glioma patients. In this study, we aimed to establish an age group classification for risk stratification in glioma patients. Methods 1502 patients diagnosed with gliomas at Nanfang Hospital between 2000 and 2018 were enrolled. The WHO grade of glioma was used as a dependent variable to evaluate the effect of age on risk stratification. The evaluation model was established by logistic regression, and the Akaike information criterion (AIC) value of the model was used to determine the optimal cutoff points for age-classification. The differences in gender, WHO grade, pathological subtype, tumor cell differentiation, tumor size, tumor location, and molecular markers between different age groups were analyzed. The molecular markers included GFAP, EMA, MGMT, P53, NeuN, Oligo2, EGFR, VEGF, IDH1, Ki-67, PR, CD3, H3K27M, TS, and 1p/19q status. Results The proportion of men with glioma was higher than that of women with glioma (58.3% vs 41.7%). Analysis of age showed that appropriate classifications of age group were 0–14 years old (pediatric group), 15–47 years old (youth group), 48–63 years old (middle-aged group), and ≥ 64 years old (elderly group).The proportions of glioblastoma and large tumor size (4–6 cm) increased with age (p = 0.000, p = 0.018, respectively). Analysis of the pathological molecular markers across the four age groups showed that the proportion of patients with larger than 10% area of Ki-67 expression or positive PR expression increased with age (p = 0.000, p = 0.017, respectively). Conclusions Appropriate classifications of the age group for risk stratification are 0–14 years old (pediatric group), 15–47 years old (young group), 48–63 years old (middle age group) and ≥ 64 years old (elderly group). This age group classification is effective in evaluating the risk of glioblastoma in glioma patients.
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Affiliation(s)
- Zhiying Lin
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Runwei Yang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Kaishu Li
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Guozhong Yi
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.,Nanfang Glioma Center, Guangzhou, 510515, Guangdong, China
| | - Zhiyong Li
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.,Nanfang Glioma Center, Guangzhou, 510515, Guangdong, China
| | - Jinglin Guo
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Zhou Zhang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Peng Junxiang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.,Nanfang Glioma Center, Guangzhou, 510515, Guangdong, China
| | - Yawei Liu
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Songtao Qi
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China.,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.,Nanfang Glioma Center, Guangzhou, 510515, Guangdong, China
| | - Guanglong Huang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong, China. .,The Laboratory for Precision Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China. .,Nanfang Glioma Center, Guangzhou, 510515, Guangdong, China.
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8
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Jakola AS, Sagberg LM, Gulati S, Solheim O. Advancements in predicting outcomes in patients with glioma: a surgical perspective. Expert Rev Anticancer Ther 2020; 20:167-177. [PMID: 32114857 DOI: 10.1080/14737140.2020.1735367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Diffuse glioma is a challenging neurosurgical entity. Although surgery does not provide a cure, it may greatly influence survival, brain function, and quality of life. Surgical treatment is by nature highly personalized and outcome prediction is very complex. To engage and succeed in this balancing act it is important to make best use of the information available to the neurosurgeon.Areas covered: This narrative review provides an update on advancements in predicting outcomes in patients with glioma that are relevant to neurosurgeons.Expert opinion: The classical 'gut feeling' is notoriously unreliable and better prediction strategies for patients with glioma are warranted. There are numerous tools readily available for the neurosurgeon in predicting tumor biology and survival. Predicting extent of resection, functional outcome, and quality of life remains difficult. Although machine-learning approaches are currently not readily available in daily clinical practice, there are several ongoing efforts with the use of big data sets that are likely to create new prediction models and refine the existing models.
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Affiliation(s)
- Asgeir Store Jakola
- Department of Clinical Neuroscience, Institute of Physiology and Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway
| | - Lisa Millgård Sagberg
- Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway.,Department of Public Health and Nursing, NTNU, Trondheim, Norway
| | - Sasha Gulati
- Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway.,Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway
| | - Ole Solheim
- Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway.,Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway
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van Lent DI, van Baarsen KM, Snijders TJ, Robe PAJT. Radiological differences between subtypes of WHO 2016 grade II-III gliomas: a systematic review and meta-analysis. Neurooncol Adv 2020; 2:vdaa044. [PMID: 32642698 PMCID: PMC7236393 DOI: 10.1093/noajnl/vdaa044] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Isocitrate dehydrogenase (IDH) mutation and 1p/19q-codeletion are oncogenetic alterations with a positive prognostic value for diffuse gliomas, especially grade II and III. Some studies have suggested differences in biological behavior as reflected by radiological characteristics. In this paper, the literature regarding radiological characteristics in grade II and III glioma subtypes was systematically evaluated and a meta-analysis was performed. METHODS Studies that addressed the relationship between conventional radiological characteristics and IDH mutations and/or 1p/19q-codeletions in newly diagnosed, grade II and III gliomas of adult patients were included. The "3-group analysis" compared radiological characteristics between the WHO 2016 glioma subtypes (IDH-mutant astrocytoma, IDH-wildtype astrocytoma, and oligodendroglioma), and the "2-group analysis" compared radiological characteristics between 1p/19q-codeleted gliomas and 1p/19q-intact gliomas. RESULTS Fourteen studies (3-group analysis: 670 cases, 2-group analysis: 1042 cases) were included. IDH-mutated astrocytomas showed more often sharp borders and less frequently contrast enhancement compared to IDH-wildtype astrocytomas. 1p/19q-codeleted gliomas had less frequently sharp borders, but showed a heterogeneous aspect, calcification, cysts, and edema more frequently. For the 1p/19q-codeleted gliomas, a sensitivity of 96% was found for heterogeneity and a specificity of 88.1% for calcification. CONCLUSIONS Significant differences in conventional radiological characteristics exist between the WHO 2016 glioma subtypes, which may reflect differences in biological behavior. However, the diagnostic value of the independent radiological characteristics is insufficient to reliably predict the molecular genetic subtype.
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Affiliation(s)
- Djuno I van Lent
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kirsten M van Baarsen
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Neuro-Oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Tom J Snijders
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pierre A J T Robe
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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