gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

The prognostic value of IDH mutations and MGMT promoter status in secondary high-grade gliomas

Meeting Abstract

  • T. Juratli - Klinik und Poliklinik für Neurochirurgie, Carl Gustav Carus Universitätsklinikum, Dresden
  • M. Kirsch - Klinik und Poliklinik für Neurochirurgie, Carl Gustav Carus Universitätsklinikum, Dresden
  • K. Geiger - Institut für Pathologie und Neuropathologie, Carl Gustav Carus Universitätsklinikum, Dresden
  • S. Souceck - Klinik und Poliklinik für Neurochirurgie, Carl Gustav Carus Universitätsklinikum, Dresden
  • G. Schackert - Klinik und Poliklinik für Neurochirurgie, Carl Gustav Carus Universitätsklinikum, Dresden
  • D. Krex - Klinik und Poliklinik für Neurochirurgie, Carl Gustav Carus Universitätsklinikum, Dresden

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.01.04

DOI: 10.3205/12dgnc168, URN: urn:nbn:de:0183-12dgnc1681

Published: June 4, 2012

© 2012 Juratli et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Reports about the prognostic value of IDH mutations and the promoter region of the O6-Methyl-guanyl-methyl-transferase (MGMT) gene in secondary high-grade gliomas (sHGG) are few in number. We analyzed the relationships among histology, IDH mutations, MGMT promoter status, treatment and outcome in 99 patients with sHGG.

Methods: Patients with sHGG were screened for IDH mutations by direct sequencing and, for promoter status of MGMT gene, by the methylation-specific-polymerase chain reaction (MsPCR).

Results: 48 of 99 patients (48.5%) had secondary anaplastic astrocytomas WHO grade III (Group 1), and 51 patients had secondary glioblastomas WHO grade IV (Group 2). The overall survival (OS) of all patients with sHGG and with an IDH mutation was, with 4 years, significantly longer than patients with wild-type IDH, with 1.2 years (p = 0.009). Patients' survival was not significantly influenced by the tumors' MGMT promoter status, both in Group 1 – with 9.7 years vs. 6.1 years, methylated vs. unmethylated promoter (p = 0.330) – as well as in Group 2 – with 1.5 years vs. 1.6 years, methylated vs. unmethylated promoter (p = 0.829). Patients treated with combined chemotherapy (CT) and radiotherapy (RT) showed a significantly improved median OS (5.6 years) compared with patients who had CT or RT alone.

Conclusions: IDH mutations are a more powerful prognostic marker than MGMT promoter status in patients with sHGG in view of the OS and PFS. Independent from the status of IDH mutations and MGMT promoter, a combined CT and RT at first diagnosis of sHGG might be more effective than monotherapy with CT or RT alone.