Clinical features, <scp>MRI</scp>, molecular alternations, and prognosis of astrocytoma based on <scp>WHO</scp> 2021 classification of central nervous system tumors: A single‐center retrospective study-Reference-Cited by-同舟云学术

Clinical features, MRI, molecular alternations, and prognosis of astrocytoma based on WHO 2021 classification of central nervous system tumors: A single‐center retrospective study

Published:2024-07 Issue:13 Volume:13 Page:
ISSN:2045-7634
Container-title:Cancer Medicine
language:en
Short-container-title:Cancer Medicine

Author:

Wang Yuekun¹,Xing Hao¹,Guo Xiaopeng¹²,Chen Wenlin¹,Wang Yaning¹^ORCID,Liang Tingyu¹,Wang Hai¹,Li Yilin¹³,Jin Shanmu¹³,Shi Yixin¹⁴,Liu Delin¹⁴,Yang Tianrui¹⁴,Xia Yu¹⁴,Li Junlin¹⁴,Wu Jiaming¹⁴,Liu Qianshu¹⁴,Qu Tian¹⁴,Guo Siying¹⁵^ORCID,Li Huanzhang¹⁴,Zhang Kun¹⁴,Wang Yu¹²^ORCID,Ma Wenbin¹²^ORCID

Affiliation:

1. Department of Neurosurgery, Center for Malignant Brain Tumors, National Glioma MDT Alliance Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

2. China Anti‐Cancer Association Specialty Committee of Glioma Beijing China

3. '4+4' Medical Doctor Program Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

4. Eight‐year Medical Doctor Program Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China

5. Tsinghua University Ringgold standard institution School of Medicine, Tsinghua University Beijing China

Abstract

AbstractBackgroundThe diagnosis of glioma has advanced since the release of the WHO 2021 classification with more molecular alterations involved in the integrated diagnostic pathways. Our study aimed to present our experience with the clinical features and management of astrocytoma, IDH mutant based on the latest WHO classification.MethodsPatients diagnosed with astrocytoma, IDH‐mutant based on the WHO 5th edition classification of CNS tumors at our center from January 2009 to January 2022 were included. Patients were divided into WHO 2–3 grade group and WHO 4 grade group. Integrate diagnoses were retrospectively confirmed according to WHO 2016 and 2021 classification. Clinical and MRI characteristics were reviewed, and survival analysis was performed.ResultsA total of 60 patients were enrolled. 21.67% (13/60) of all patients changed tumor grade from WHO 4th edition classification to WHO 5th edition. Of these, 21.43% (6/28) of grade II astrocytoma and 58.33% (7/12) of grade III astrocytoma according to WHO 4th edition classification changed to grade 4 according to WHO 5th edition classification. Sex (p = 0.042), recurrent glioma (p = 0.006), and Ki‐67 index (p < 0.001) of pathological examination were statistically different in the WHO grade 2–3 group (n = 27) and WHO grade 4 group (n = 33). CDK6 (p = 0.004), FGFR2 (p = 0.003), and MYC (p = 0.004) alterations showed an enrichment in the WHO grade 4 group. Patients with higher grade showed shorter mOS (mOS = 75.9 m, 53.6 m, 26.4 m for grade 2, 3, and 4, respectively, p = 0.01).ConclusionsPatients diagnosed as WHO grade 4 according to the 5th edition WHO classification based on molecular alterations are more likely to have poorer prognosis. Therefore, treatment should be tailored to their individual needs. Further research is needed for the management of IDH‐mutant astrocytoma is needed in the future.

Funder

Beijing Municipal Natural Science Foundation

Publisher

Wiley

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1002/cam4.7369

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