Gliomas: Analysis of disease characteristics, treatment timelines and survival rates from two tertiary care hospitals of India

Mukundan, Hari; Singh, Sankalp; Lohia, Nishant; Taneja, Sameer; Sarin, Arti; Bhatnagar, S. S.; Jaiswal, Pradeep; Trivedi, Gaurav; Prasher, Manoj; Sundaram, Vinay

doi:10.4103/ccij.ccij_27_20

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…CNS tumors are associated with very high mortality and morbidity which makes them the most feared form of cancer [2]. Moreover, the difficulty in accessing the CNS tumor tissue, its fragile nature, small specimen size also pose problems in diagnosis [3] apart from the inherent complexities of brain tumors and also lack of uniformity future tailored and targeted therapy. Molecular diagnosis has been given utmost importance so much so as to even supersede the gold standard histology which we have been following since ages [5].…”

Section: Introductionmentioning

confidence: 99%

Significance and Impact of Changing WHO Classification Systems on Glial Tumors with Special Reference to IDH1 Mutation in Resource-Limited Setups

Singh,

Misra,

Varma

2023

Asian Pac J Cancer Biol

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Objectives: To reclassify glial neoplasms according to the 2021 WHO CNS tumor classification and to study the expression pattern of Isocitrate dehydrogenase 1 (IDH1) mutation by immunohistochemistry(IHC) and to categorize these tumors on the basis of IDH1 mutation. Methods: This retrospective study included patients who were diagnosed as glial tumors on histology (n=60). A detailed clinical history and radiological findings were obtained. Patients above 18 years were taken as adults while age upto 18 years were included in pediatric group. IHC for IDH1 mutation was done using Anti-IDH1 (R132H) antibody. Results: Among all glial tumors, 51.7% (31/60) were assigned IDH1 mutant status and the remaining i.e. 48.3% (29/60) were assigned IDH1 wildtype status. While classifying diffuse gliomas according to age, site and morphology, it was observed that the relative proportion of IDH1 mutant and IDH1 wildtype categories in the adult age group was 56.8% (25/44 cases) and 43.2% (19/44 cases) respectively while in the pediatric age group it was 45.5% (5/11 cases) and 54.5% (6/11 cases) respectively. Among the other glial and glioneuronal tumors majority were IDH1 wildtype (80.0%). Most of the WHO grade 1 tumors were IDH1 wildtype (71.4%, 5/7) whereas Grade 2 and 3 tumors were IDH1 mutant (83.3%, 15/18 and 100.0%, 5/5 respectively). On the other hand in Grade 4 tumors there was a higher proportion of neoplasms exhibiting IDH1 wildtype status (70.0%, 21/30). Conclusion: Identification of IDH status as mutant and wildtype is crucial in glial tumors (especially glioblastoma) because both these groups are clinically, genetically, biologically and prognostically different. IHC provides a standard alternative for molecular studies with high sensitivity and specificity with quick, economical and standard results especially useful in resource-poor countries. Reclassification according to the latest WHO classification appears to confer a overall better prognosis than the previous classifications and this study can also provide a base for future larger research avenues and treatment based on IDH1 mutation.

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Section: Introductionmentioning

confidence: 99%

Significance and Impact of Changing WHO Classification Systems on Glial Tumors with Special Reference to IDH1 Mutation in Resource-Limited Setups

Singh,

Misra,

Varma

2023

Asian Pac J Cancer Biol

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Challenges to Early Detection of Brain Tumors in Low- and Middle-Income Countries: A Systematic Review

Shakir,

Shariq,

Tahir

et al. 2024

World Neurosurgery

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Prognostic significance of STAT3 gene expression in patients with glioblastoma tumors: a study from Western India

Trivedi

Panchal

Bhalala

et al. 2022

J Egypt Natl Canc Inst

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Objective Glioblastoma Multiforme (GBM), a devastating the most common primary malignant intracranial brain tumors. In India, the incidence of this malignancy is escalating, however, there are very few studies on this tumor entity from Indian population. The present study sought to investigate the prevalence and prognostic significance of Signal Transducer and Activator of Transcription 3 (STAT3) gene expression in GBM patients from Western India. Method STAT3 gene expression using real-time PCR was detected in total 55 GBM patients. The impact of STAT3 aberrant expression on progression-free survival (PFS) and overall (OS) was analysed using univariate and multivariate survival analysis. The data were analysed using SPSS statistical software and p value ≤0.05 was considered as significant. Results The aberrant STAT3 expression was found in 85% (47/55) of patients with -1.12 fold change down-regulation in 49% (23/47) and 3.36 fold change up-regulation was noted in 51% (24/47) of patients. In wild type IDH tumors (n=30), down regulation and up regulation of STAT3 was noted in 63% and 27% of patients, respectively, whereas, for IDH mutant GBM tumors (n=25), the incidence of low expression and high expression of STAT3 was noted in 16% and 68% of patients, respectively. Thus, we found that incidence of STAT3 down regulation was significantly high in patients with IDH wild type tumors, whereas, in IDH mutant GBM tumors, the incidence of up-regulated STAT3 was significantly high (P=0.021, χ2=12.81, r=+0.310). In Kaplan-Meier univariate survival analysis, a part from age (P=0.006), tumor location (P=0.025), and KPS score (P=0.002), co-detection of STAT3 up regulation and presence of IDH mutation (P=0.030) remained significant prognostic factors for PFS and OS. In multivariate survival analysis also, co-detection of STAT3 high expression and presence of IDH mutation remained independent prognosticators for PFS (HR=6.45, 95% CI=1.32-31.40, P=0.021) and OS (HR=8.69, 95% CI=1.66-45.51, P=0.010). Conclusion For GBM tumors, STAT3 up-regulation and presence of IDH mutations together predicts better survival. This reflects unique molecular etiology for GBM patients. Therefore, they would be useful in the future for targeted therapy and for clinicians they would be useful for better patient management. However, study on a larger sample size is required for validation.

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Gliomas: Analysis of disease characteristics, treatment timelines and survival rates from two tertiary care hospitals of India

Cited by 3 publications

References 20 publications

Significance and Impact of Changing WHO Classification Systems on Glial Tumors with Special Reference to IDH1 Mutation in Resource-Limited Setups

Significance and Impact of Changing WHO Classification Systems on Glial Tumors with Special Reference to IDH1 Mutation in Resource-Limited Setups

Challenges to Early Detection of Brain Tumors in Low- and Middle-Income Countries: A Systematic Review

Prognostic significance of STAT3 gene expression in patients with glioblastoma tumors: a study from Western India

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