Lack of complete 1p19q deletion in a consecutive series of 12 WHO grade II gliomas involving the insula: a marker of worse prognosis?

2008 ◽  
Vol 91 (1) ◽  
pp. 1-5 ◽  
Author(s):  
C. Gozé ◽  
V. Rigau ◽  
L. Gibert ◽  
T. Maudelonde ◽  
H. Duffau
Keyword(s):  
Consecutive Series ◽  
Who Grade ◽  
Grade Ii ◽  
Who Grade Ii Gliomas ◽  
Worse Prognosis

Distinct IDH1/IDH2 mutation profiles in purely insular versus paralimbic WHO Grade II gliomas

2013 ◽  
Vol 118 (4) ◽  
pp. 866-872 ◽  
Author(s):  
Catherine Gozé ◽  
Lamisse Mansour ◽  
Valérie Rigau ◽  
Hugues Duffau
Keyword(s):  
Molecular Profile ◽  
Consecutive Series ◽  
Who Grade ◽  
1P19q Codeletion ◽  
Tumor Group ◽  
Significant Difference ◽  
Temporal Structures ◽  
Grade Ii ◽  
Who Grade Ii Gliomas ◽  
Grade Ii Glioma

Object The molecular profile of diffuse WHO Grade II gliomas involving the insular lobe, with a possible impact on outcome, is controversial. The authors undertook this study to investigate a possible difference of molecular patterns between purely insular Grade II gliomas and paralimbic Grade II gliomas that involve both the insular lobe and the frontal and/or temporal structures. Methods From a consecutive series of 47 patients who underwent resection of a Grade II glioma invading the insula, 2 subgroups were identified. The first subgroup included 11 patients with a purely insular tumor. The second subgroup included 36 patients with a paralimbic Grade II glioma also involving the frontal and/or temporal lobe. The authors searched systematically for TP53 mutations, 1p19q codeletion, and IDH1/IDH2 mutations. Results There was no significant difference between the 2 subgroups with respect to 1p19q codeletion or TP53 mutations rates. Conversely, IDH1/IDH2 mutations were found in all 11 (100%) of the insular Grade II gliomas but only 20 (55%) of 36 paralimbic Grade II gliomas (p = 0.008). Ten (28%) of the 36 patients in the paralimbic tumor group experienced a malignant transformation, and 6 of them died; whereas neither transformation nor death occurred in the insular tumor group (trend toward significance, p = 0.088). Conclusions These findings demonstrate for the first time distinct IDH1/IDH2 and consequently distinct “triplenegative” patterns in purely insular versus paralimbic Grade II gliomas. Such findings could explain discrepancies reported in the literature, because insular and paralimbic gliomas have not been separated in previous reports. These results may enable physicians to refine the management of Grade II gliomas involving the insula according to the presence or lack of invasion of the frontal and/or temporal areas.

Clear cell histology portends a worse prognosis than other WHO grade II histologies

2021 ◽  
Author(s):  
Pranay Soni ◽  
Jianning Shao ◽  
Arbaz Momin ◽  
Diana Lopez ◽  
Lilyana Angelov ◽  
...  
Keyword(s):  
Clear Cell ◽  
Who Grade ◽  
Grade Ii ◽  
Worse Prognosis

Surgery for Diffuse WHO Grade II Gliomas: Volumetric Analysis of a Multicenter Retrospective Cohort From the German Study Group for Intraoperative Magnetic Resonance Imaging

Neurosurgery ◽  
2019 ◽  
Vol 86 (1) ◽  
pp. E64-E74 ◽  
Author(s):  
Moritz Scherer ◽  
Hajrulla Ahmeti ◽  
Constantin Roder ◽  
Florian Gessler ◽  
Christine Jungk ◽  
...  
Keyword(s):  
Regression Models ◽  
Cox Regression ◽  
Study Group ◽  
Incomplete Resection ◽  
Who Grade ◽  
German Study ◽  
Significant Survival ◽  
Idh Mutations ◽  
Grade Ii ◽  
Who Grade Ii Gliomas

Abstract BACKGROUND In diffuse WHO grade II gliomas (LGG), the extent of resection (EOR) required to achieve significant survival benefits remains elusive. OBJECTIVE To evaluate the association of residual volume (RV) and EOR with progression-free survival (PFS) or overall survival (OS) in LGG in a retrospective, multicenter series by the German study group of intraoperative MRI (GeSGIM). METHODS Consecutive cases were retrospectively assessed from 5 centers. Tumors were volumetrically quantified before and after surgery, and clinical data were analyzed, including IDH mutations and neurologic deficits. Kaplan–Meier estimates, accelerated failure time models (AFT), and multivariate Cox regression models were calculated to identify determinants of survival. RESULTS A total of 140 cases were analyzed. Gross total resection (GTR) was associated with significantly longer PFS compared to any incomplete resection (P = .009). A significant survival disadvantage was evident even for small (>0-5 ml) residuals and increased for moderate (>5-20 ml) and large remnants (>20 ml) P = .001). Accordingly, PFS increased continuously for 20% incremental steps of EOR (P < .001). AFT models supported the notion of a continuous association of RV and EOR with PFS. Multivariate Cox regression models confirmed RV (P = .01) and EOR (P = .005) as continuous prognosticators of PFS. Univariate analysis showed significant associations of RV and EOR with OS. CONCLUSION Our data support the hypothesis of a continuous relationship of RV and EOR with survival for LGG with superiority seen for GTR. Hence, GTR should be achieved whenever safely feasible, and resections should be maximized whenever tumor has to be left behind to spare function.

Infiltrative Astrocytomas

2017 ◽  
Author(s):  
Aaron Mammoser
Keyword(s):  
Young Adults ◽  
Anaplastic Astrocytoma ◽  
Genetic Profile ◽  
Who Grade ◽  
Secondary Glioblastoma ◽  
Primary Glioblastoma ◽  
Molecular Abnormalities ◽  
Mutation Pattern ◽  
Grade Ii ◽  
Worse Prognosis

Diffuse astrocytomas are WHO grade II astrocytomas that are distinguished from other WHO grade I and II astrocytomas because they are infiltrative, incurable, and have an intrinsic tendency to undergo malignant transformation to an anaplastic astrocytoma or a secondary glioblastoma. They are most often diagnosed in young adults in their 30s and 40s, and have a genetic profile that is different than primary glioblastoma. Anaplastic astrocytomas frequently arise from diffuse astroctyomas and share many of the same molecular abnormalities but tend to acquire more as they inevitably progress to glioblastoma. Recent studies identified mutations associated with WHO grade II and III tumors that predict a progression to a secondary glioblastoma with a better overall prognosis than primary glioblastoma. WHO grade II and III tumors that do not exhibit this typical mutation pattern often behave more aggressively than their counterparts, with a worse prognosis than higher grade tumors with a more favorable genotype.

scholarly journals ACTR-20. EFFICACY OF INITIAL TEMOZOLOMIDE FOR HIGH-RISK LOW GRADE GLIOMAS IN A PHASE II AINO (ITALIAN ASSOCIATION FOR NEURO-ONCOLOGY) STUDY: A POST-HOC ANALYSIS WITHIN MOLECULAR SUBGROUPS OF WHO 2016

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi16-vi17
Author(s):  
Roberta Rudà ◽  
Alessia Pellerino ◽  
Andrea Pace ◽  
Carmine Maria Carapella ◽  
Cristina Dealis ◽  
...  
Keyword(s):  
High Risk ◽  
Phase Ii ◽  
Response Rate ◽  
Long Term Results ◽  
Molecular Subgroups ◽  
Who Grade ◽  
Post Hoc Analysis ◽  
Grade Ii ◽  
Post Hoc ◽  
Who Grade Ii Gliomas

Abstract BACKGROUND The optimal management of high risk WHO grade II gliomas after surgery is still debated. The efficacy of initial temozolomide to delay radiotherapy and risk of cognitive defects could vary across the molecular subgroups of WHO 2016, but information on this issue are lacking. PATIENTS AND METHODS A post-hoc analysis has been performed on a cohort of high risk WHO grade II gliomas, who received initial temozolomide alone in phase II multicenter study, with the objective of re-evaluating the long-term results across the different molecular subgroups of the WHO 2016 classification. The primary endpoint of the study, carried out between 2007 and 2010, was response rate according to RANO, being seizure response, PFS and OS secondary endpoints. RESULTS Response rate (partial and minor responses) among oligodendrogliomas IDH-mutant and 1p/19q codeleted (76%) was significantly higher than that among diffuse astrocytomas either mutant (55%) or wild-type (36%). A reduction of seizure frequency >50% was observed in 87% patients and a seizure freedom in 72%. The probability of seizure reduction >50% was significantly associated with the presence of an IDH mutation. Median PFS, PFS at 5 and 10 years, median OS and OS at 5 and 10 years were all significantly longer in oligodendrogliomas IDH-mutant and 1p/19q codeleted. Of patients who did not recur or delay radiotherapy at recurrence for a median follow-up of 8.2 years, 67% and 59%, respectively, were oligodendrogliomas IDH-mutant and 1p/19q codeleted. CONCLUSIONS The post-hoc analysis of this phase II trial suggests that the beneficial effects of initial temozolomide prevail in oligodendrogliomas IDH-mutant and 1p/19q codeleted: thus, these tumors, when incompletely resected or progressive after surgery, especially when suffering from pharmacoresistant seizures, could receive temozolomide as initial treatment with radiotherapy and chemotherapy at recurrence. The trial was registered with EU Clinical Trials Register, EudraCT n. 2007/000386-38.

scholarly journals Prognostic significance of imaging contrast enhancement for WHO grade II gliomas

2009 ◽  
Vol 11 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Johan Pallud ◽  
Laurent Capelle ◽  
Luc Taillandier ◽  
Denys Fontaine ◽  
Emmanuel Mandonnet ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Prognostic Significance ◽  
Who Grade ◽  
Grade Ii ◽  
Who Grade Ii Gliomas

scholarly journals Hot spots in dynamic18FET-PET delineate malignant tumor parts within suspected WHO grade II gliomas

2011 ◽  
Vol 13 (3) ◽  
pp. 307-316 ◽  
Author(s):  
M. Kunz ◽  
N. Thon ◽  
S. Eigenbrod ◽  
C. Hartmann ◽  
R. Egensperger ◽  
...  
Keyword(s):  
Malignant Tumor ◽  
Hot Spots ◽  
Who Grade ◽  
Grade Ii ◽  
Who Grade Ii Gliomas

Combination of neoadjuvant chemotherapy followed by surgical resection as a new strategy for WHO grade II gliomas: a study of cognitive status and quality of life

2011 ◽  
Vol 106 (2) ◽  
pp. 353-366 ◽  
Author(s):  
Marie Blonski ◽  
Luc Taillandier ◽  
Guillaume Herbet ◽  
Igor Lima Maldonado ◽  
Patrick Beauchesne ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neoadjuvant Chemotherapy ◽  
Surgical Resection ◽  
Cognitive Status ◽  
Who Grade ◽  
New Strategy ◽  
Grade Ii ◽  
Who Grade Ii Gliomas

A personal consecutive series of surgically treated 51 cases of insular WHO Grade II glioma: advances and limitations

2009 ◽  
Vol 110 (4) ◽  
pp. 696-708 ◽  
Author(s):  
Hugues Duffau
Keyword(s):  
Posterior Part ◽  
Surgical Removal ◽  
Consecutive Series ◽  
Glioma Surgery ◽  
Who Grade ◽  
Additional Surgery ◽  
Grade Ii ◽  
The Impact ◽  
Grade Ii Glioma

Object Few experiences of insular surgery have been reported. Moreover, there are no large surgical studies with long-term follow-up specifically dedicated to WHO Grade II gliomas involving the insula. In this paper, the author describes a personal consecutive series of 51 cases in which patients underwent surgery for an insular Grade II glioma. On the basis of the functional and oncological results, advances and limitations of this challenging surgery are discussed. Methods Fifty-one patients harboring an insular Grade II glioma (revealed by seizures in 50 cases) underwent surgery. Findings on preoperative neurological examination were normal in 45 patients (88%). All surgeries were conducted under cortico-subcortical stimulation, and in the case of 16 patients while awake. Results Despite an immediate postoperative worsening in 30 cases (59%), the condition of all but 2 patients (96%) returned to baseline or better. Postoperative MR imaging demonstrated that 77% of resections were total or subtotal. Ten patients underwent a second or third surgery, with no additional deficit. Forty-two patients (82%) are alive with a median follow-up of 4 years. Conclusions This is the largest reported experience with insular Grade II glioma surgery. The better knowledge of the insular pathophysiology and the use of intraoperative functional mapping allow the risk of permanent deficit to be minimized (and even enable improvement in quality of life) while increasing the extent of resection and thus the impact on the course of the disease. Therefore, surgical removal must always be considered for insular Grade II glioma. However, this surgery remains challenging, especially within the anterior perforating substance and the posterior part of the (dominant) insula. Additional surgery can be suggested in cases in which the first resection is not complete.

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