Gabbai, Alberto A.;
(2020)
Lower-grade gliomas: a single-centre analysis of 218 patients.
Masters thesis (M.Phil), UCL (University College London)..
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Abstract
Lower-grade gliomas (LGG) are the most common tumours of the central nervous system in young adults. They were classified by the 2007 World Health Organization (WHO) as Grade II and III in astrocytomas, oligoastrocytomas and oligodendrogliomas, as part of a grading system (I, to IV) aiming to predict the biological behavior of a neoplasm (I benign – IV malignant). But due to the interobserver variability in the distinction between WHO grades II and III, and in the definition of the oligoastrocytomas, a new 2016 revised WHO Classification introduced an integrated phenotypic and genotypic classification that was aimed to minimize diagnostic variability. The two most important molecular markers for the diagnosis of LGG are the IDH- and the 1p/19q-molecular status. Hence, our main purpose herein was to confirm or refute the extant evidence that patients with IDH-wildtype tumours do have a significantly lower overall and progression-free survivals compared with those with IDH-mutant tumours. We analyzed a single-institution cohort of 218 patients with lower-grade gliomas diagnosed between 2009 -2015, according to the 2007 WHO Classification, but also with results of IDH and 1p/19q status, the two defining molecular markers for lower-grade gliomas set by the 2016 Classification. We present their demographics, pathologic data and overall (OS) and progression-free (PFS) survivals, associated with histologic class, WHO grade and molecular subtypes. There were 118 males and 100 females; 94 astrocytomas, 45 oligoastrocytomas and 79 oligodendrogliomas. 154 were IDH-mutant (71, 1p/19q-codeleted and 81, 1p/19q-retained, and unknown in 2) and 64, IDH-wildtype. The longest median OS (20.45 years) was found for oligoastrocytomas grade II, oligoastrocytomas IDH-mutant and LGG IDH mutant 1p/19q-codeleted grade II. The shortest median OS was 1.24 years for LGG IDH wild-type grade III. Oligoastrocytomas IDH-wildtype, and astrocytomas IDH-wildtype had OS of 1.5 years. The longest median PFS was 6.72 years for oligodendrogliomas IDH-mutant, and the shortest was for LGG IDH-wildtype grade III (0.74 years). We have found that in LGG, the IDH molecular marker is the most important predictor of outcome, over and above histologic class and tumor grade.
| Type: | Thesis (Masters) |
|---|---|
| Qualification: | M.Phil |
| Title: | Lower-grade gliomas: a single-centre analysis of 218 patients |
| Event: | UCL (University College London). |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10104754 |
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