Clinical management and survival outcomes of patients with different molecular subtypes of diffuse gliomas in China (2011–2017): a multicenter retrospective study from CGGA

Abstract

Objective: We aimed to summarize the clinicopathological characteristics and prognostic features of various molecular subtypes of diffuse gliomas (DGs) in the Chinese population. Methods: In total, 1,418 patients diagnosed with DG between 2011 and 2017 were classified into 5 molecular subtypes according to the 2016 WHO classification of central nervous system tumors. The IDH mutation status was determined by immunohistochemistry and/or DNA sequencing, and 1p/19q codeletion was detected with fluorescence in situ hybridization. The median clinical follow-up time was 1,076 days. T-tests and chi-square tests were used to compare clinicopathological characteristics. Kaplan-Meier and Cox regression methods were used to evaluate prognostic factors. Results: Our cohort included 15.5% lower-grade gliomas, IDH-mutant and 1p/19q-codeleted (LGG-IDHm-1p/19q); 18.1% lower-grade gliomas, IDH-mutant (LGG-IDHm); 13.1% lower-grade gliomas, IDH-wildtype (LGG-IDHwt); 36.1% glioblastoma, IDH-wildtype (GBM-IDHwt); and 17.2% glioblastoma, IDH-mutant (GBM-IDHm). Approximately 63.3% of the enrolled primary gliomas, and the median overall survival times for LGG-IDHm, LGG-IDHwt, GBM-IDHwt, and GBM-IDHm subtypes were 75.97, 34.47, 11.57, and 15.17 months, respectively. The 5-year survival rate of LGG-IDHm-1p/19q was 76.54%. We observed a significant association between high resection rate and favorable survival outcomes across all subtypes of primary tumors. We also observed a significant role of chemotherapy in prolonging overall survival for GBM-IDHwt and GBM-IDHm, and in prolonging post-relapse survival for the 2 recurrent GBM subtypes. Conclusions: By controlling for molecular subtypes, we found that resection rate and chemotherapy were 2 prognostic factors associated with survival outcomes in a Chinese cohort with DG.

Management of IDH-mutant astrocytoma based on WHO 2021 classification of central nervous system tumors: a single center retrospective study

“…The treatment regimen remained lack of evidences under new classi cation of IDH-mutant astrocytoma, WHO grade 4. A multi-center study shown that patients with primary IDH-mutant glioblastoma can have an overall survival bene t from TMZ and concurrent radiochemotherapy [12]. Followed the progression of WHO 4 glioblastoma/astrocytoma, the recurrent IDH-mutant astrocytoma was less likely to extend beyond gross tumor volume and indicated a modi ed plan of radiotherapy or radiochemotherapy [13].…”

scRNA‐seq and proteomics reveal the distinction of M2‐like macrophages between primary and recurrent malignant glioma and its critical role in the recurrence

“…Previous studies have associated the molecular features of glioma with clinical classification. Patients with glioma without IDH mutant or 1p/19q co‐deleted had worse outcomes 62–64 . In addition, tumors with different IDH and 1p/19q status undergo distinct cell‐state changes at recurrence, which may interfere with the comparison of the microenvironment between primary gliomas and recurrent gliomas.…”

Unveiling the Influence of Tumor Microenvironment and Spatial Heterogeneity on Temozolomide Resistance in Glioblastoma Using an Advanced Human In Vitro Model of the Blood‐Brain Barrier and Glioblastoma

“…[47] The Chinese Glioma Genome Atlas (CGGA) cohort (n = 693 tumors) processed RNAseq was downloaded from http://cgga.org.cn/. [102][103][104][105] Statistical Analysis: All data points were plotted and analyzed. N > 3 for all experiments, and are specifically stated in figure legends.…”