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Clinical and radiographic characteristics of diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma: a single institution review
Purpose Genetic analyses of gliomas have identified key molecular features that impact treatment paradigms beyond conventional histomorphology. Despite at-times lower grade histopathologic appearances, IDH -wildtype infiltrating gliomas expressing certain molecular markers behave like higher-grade t...
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Published in: | Journal of neuro-oncology 2022-03, Vol.157 (1), p.187-195 |
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Main Authors: | , , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Purpose
Genetic analyses of gliomas have identified key molecular features that impact treatment paradigms beyond conventional histomorphology. Despite at-times lower grade histopathologic appearances,
IDH
-wildtype infiltrating gliomas expressing certain molecular markers behave like higher-grade tumors. For
IDH
-wildtype infiltrating gliomas lacking traditional features of glioblastoma, these markers form the basis for the novel diagnosis of
diffuse astrocytic glioma, IDH-wildtype
(wt)
, with molecular features of glioblastoma
(GBM)
, WHO grade-IV
(DAG-G). However, given the novelty of this approach to diagnosis, literature detailing the exact clinical, radiographic, and histopathologic findings associated with these tumors remain in development.
Methods
Data for 25 patients matching the DAG-G diagnosis were obtained from our institution’s retrospective database. Information regarding patient demographics, treatment regimens, radiographic imaging, and genetic pathology were analyzed to determine association with clinical outcomes.
Results
The initial radiographic findings, histopathology, and symptomatology of patients with DAG-G were similar to lower-grade astrocytomas (WHO grade 2/3). Overall survival (OS) and progression free survival (PFS) associated with our cohort, however, were similar to that of
IDH
-wt GBM, indicating a more severe clinical course than expected from other associated features (15.1 and 5.39 months respectively).
Conclusion
Despite multiple features similar to lower-grade gliomas, patients with DAG-G experience clinical courses similar to GBM. Such findings reinforce the need for biopsy and subsequent analysis of molecular features associated with any astrocytoma regardless of presenting characteristics. |
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ISSN: | 0167-594X 1573-7373 |
DOI: | 10.1007/s11060-022-03961-5 |