The role of clinical and molecular factors in low-grade gliomas: what is their impact on survival?

Future Oncol. 2018 Jul;14(16):1559-1567. doi: 10.2217/fon-2017-0634. Epub 2018 Jun 25.

Abstract

Aim: To evaluate relevance of clinical and molecular factors in adult low-grade gliomas (LGG) and to correlate with survival.

Methods: We reviewed records from adult LGG patients from 1991 to 2015 who received surgery and had sufficient tissue to molecular biomarkers characterization.

Results: 213 consecutive LGG patients were included: 17.4% were low-risk, according to Radiation Therapy Oncology Group (RTOG) risk assessment. IDH 1/2 mutation, 1p/19q co-deletion, MGMT methylation were found in 93, 50.8 and 65.3% of patients. Median follow-up was 98.3 months. In univariate analysis, overall survival was influenced by extent of resection (p = 0.011), IDH mutation (p < 0.001), 1p/19q co-deletion (p = 0.015) and MGMT methylation (p = 0.013). In multivariate analysis, RTOG clinical risk (p = 0.006), IDH mutation (p < 0.001) and 1p/19q co-deletion (p = 0.035) correlated with overall survival. RTOG clinical risk (p = 0.006), IDH mutation (p < 0.001) and 1p/19q co-deletion (p = 0.035) correlated with overall survival.

Conclusion: Both clinical and molecular factors are essential to determine prognosis and treatment strategies.

Keywords: 1p19q co-deletion; IDH 1/2; IDH mutation; MGMT methylation; NGS; low-grade gliomas; surgery; treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Neoplasms / genetics*
  • Brain Neoplasms / mortality*
  • Brain Neoplasms / therapy
  • Chromosome Deletion
  • Chromosomes, Human, Pair 1
  • Cohort Studies
  • DNA Modification Methylases / genetics
  • DNA Repair Enzymes / genetics
  • Female
  • Glioma / genetics*
  • Glioma / mortality*
  • Glioma / therapy
  • Humans
  • Isocitrate Dehydrogenase / genetics
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Mutation
  • Neurosurgical Procedures
  • Prognosis
  • Risk Factors
  • Tumor Suppressor Proteins / genetics

Substances

  • Tumor Suppressor Proteins
  • IDH2 protein, human
  • Isocitrate Dehydrogenase
  • IDH1 protein, human
  • DNA Modification Methylases
  • MGMT protein, human
  • DNA Repair Enzymes

Supplementary concepts

  • Chromosome 1, monosomy 1p