TY - JOUR
T1 - Clinical and radiographic characteristics of diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma
T2 - a single institution review
AU - Grogan, Dayton
AU - Bray, David P.
AU - Cosgrove, Megan
AU - Boucher, Andrew
AU - Erwood, Andrew
AU - Linder, Daniel F.
AU - Mendoza, Pia
AU - Morales, Bryan
AU - Pradilla, Gustavo
AU - Nduom, Edjah K.
AU - Neill, Stewart
AU - Olson, Jeffrey J.
AU - Hoang, Kimberly B.
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/3
Y1 - 2022/3
N2 - 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.
AB - 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.
KW - Astrocytic Glioma
KW - Clinical Description
KW - Glioblastoma
KW - IDH-wildtype
KW - Molecular Markers
UR - http://www.scopus.com/inward/record.url?scp=85125928472&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85125928472&partnerID=8YFLogxK
U2 - 10.1007/s11060-022-03961-5
DO - 10.1007/s11060-022-03961-5
M3 - Comment/debate
C2 - 35212929
AN - SCOPUS:85125928472
SN - 0167-594X
VL - 157
SP - 187
EP - 195
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 1
ER -