重新评估中枢神经系统 WHO 3 级少突胶质瘤 IDH 突变和 1p/19q 共同删除的预后因素:从法国 POLA 队列中汲取的教训。

IF 16.4 1区 医学 Q1 CLINICAL NEUROLOGY Neuro-oncology Pub Date : 2024-10-21 DOI:10.1093/neuonc/noae221
Domique Figarella-Branger, Carole Colin, Karima Mokhtari, Emmanuelle Uro-Coste, Ahmed Idbaih, Romain Appay, Emeline Tabouret, Mehdi Touat, Antoine Seyve, Catherine Carpentier, Caroline Dehais, François Ducray
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To identify the impact of the pathological groups and contrast enhancement in group 1 on overall survival (OS) or progression free survival (PFS), survival curves were obtained (Kaplan-Meier method) and compared (log-rank test). Prognostic value of clinical factors and CDKN2A homozygous deletion HD were also tested. Multivariate analysis was performed.</p><p><strong>Results: </strong>Survival analysis demonstrated that the pathological groups were associated with both progression-free survival (PFS P=0.01) and overall survival (OS P=0.001). In group 1, patients with contrast enhancement (1CE+) had a poorer prognosis compared to those without (OS P=0.028, PFS P=0.006). Further stratification into group 1CE-, group 1CE+, group 2, and group 3 provided clearer prognostic distinctions (OS P=0.002, PFS P<0.0001). 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引用次数: 0

摘要

背景:在POLA队列中,描述了中枢神经系统WHO 3级少突胶质细胞瘤IDH突变和1p/19q共缺失的三个病理组别:第1组(仅有丝分裂计数高)、第2组(微血管增生MVP和无坏死)和第3组(MVP和坏死)。方法:纳入了POLA队列中的494例患者,中位随访时间为96个月。为了确定病理分组和第 1 组对比度增强对总生存期(OS)或无进展生存期(PFS)的影响,研究人员绘制了生存曲线(Kaplan-Meier 法)并进行了比较(log-rank 检验)。此外,还检验了临床因素和 CDKN2A 同源缺失 HD 的预后价值。进行了多变量分析:生存期分析表明,病理分组与无进展生存期(PFS P=0.01)和总生存期(OS P=0.001)相关。在第 1 组中,有对比增强(1CE+)的患者与无对比增强的患者相比预后较差(OS P=0.028,PFS P=0.006)。进一步将患者分为 1CE- 组、1CE+ 组、2 组和 3 组后,预后区分更加明确(OS P=0.002,PFS PConclusion):坏死和CDKN2A HD是WHO 3级少突胶质瘤、IDH突变和1p/19q共缺失的不良预后因素。此外,在第1组患者中,缺乏对比增强是预后较好的一个因素。
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Reappraisal of prognostic factors in CNS WHO grade 3 oligodendrogliomas IDH-mutant and 1p/19q co-deleted: lessons from the French POLA cohort.

Background: In POLA cohort, three pathological groups of CNS WHO grade 3 oligodendroglioma IDH-mutant and 1p/19q co-deleted have been described: group 1 (high mitotic count only), group 2 (microvascular proliferation MVP and no necrosis), and group 3 (MVP and necrosis).

Methods: 494 patients from the POLA cohort, with a median follow up of 96 months were included. To identify the impact of the pathological groups and contrast enhancement in group 1 on overall survival (OS) or progression free survival (PFS), survival curves were obtained (Kaplan-Meier method) and compared (log-rank test). Prognostic value of clinical factors and CDKN2A homozygous deletion HD were also tested. Multivariate analysis was performed.

Results: Survival analysis demonstrated that the pathological groups were associated with both progression-free survival (PFS P=0.01) and overall survival (OS P=0.001). In group 1, patients with contrast enhancement (1CE+) had a poorer prognosis compared to those without (OS P=0.028, PFS P=0.006). Further stratification into group 1CE-, group 1CE+, group 2, and group 3 provided clearer prognostic distinctions (OS P=0.002, PFS P<0.0001). Other prognostic factors included age (OS P<0.0001, PFS P=0.002), extent of surgical resection (OS P=0.001, PFS P=0.003), KPS (OS P<0.0001, PFS P=0.002), postoperative treatment (OS P=0.007, PFS P<0.0001), and CDKN2A HD (OS and PFS P<0.0001). The pathological groups remained of prognostic significance for PFS in multivariate analysis.

Conclusion: Necrosis and CDKN2A HD are adverse prognostic factors of WHO grade 3 oligodendrogliomas, IDH mutant and 1p/19q co-deleted. Besides, in group 1 patients, lack of contrast enhancement is a factor of better prognosis.

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来源期刊
Neuro-oncology
Neuro-oncology 医学-临床神经学
CiteScore
27.20
自引率
6.30%
发文量
1434
审稿时长
3-8 weeks
期刊介绍: Neuro-Oncology, the official journal of the Society for Neuro-Oncology, has been published monthly since January 2010. Affiliated with the Japan Society for Neuro-Oncology and the European Association of Neuro-Oncology, it is a global leader in the field. The journal is committed to swiftly disseminating high-quality information across all areas of neuro-oncology. It features peer-reviewed articles, reviews, symposia on various topics, abstracts from annual meetings, and updates from neuro-oncology societies worldwide.
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