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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Correlation of molecular tumour markers and tumour localisation in low-grade and grade III gliomas

Zusammenhang zwischen Tumorlokalisation und molekularen Tumormarkern bei Low-Grade- und WHO-Grad-III-Gliomen

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  • presenting/speaker Peter Georg Knapp - Neurokopfzentrum Klinikum rechts der Isar, Neurochirurgie, München, Deutschland
  • Jens Gempt - Neurokopfzentrum Klinikum rechts der Isar, Neurochirurgie, München, Deutschland
  • Hanno Meyer - Neurokopfzentrum Klinikum rechts der Isar, Neurochirurgie, München, Deutschland
  • Carl Ketterer - Neurokopfzentrum Klinikum rechts der Isar, Neurochirurgie, München, Deutschland
  • Anna-Maria Wasmeier - Neurokopfzentrum Klinikum rechts der Isar, Neurochirurgie, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP048

doi: 10.3205/19dgnc386, urn:nbn:de:0183-19dgnc3861

Published: May 8, 2019

© 2019 Knapp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The new WHO classification of 2016 reveals the important role biomarkers now play in neurooncology, both diagnostically for more precise classification into clinically relevant entities as well as predictively and prognostically. The aim of this study was to find out whether the location and the molecular profile of gliomas are related. The group of lower grade gliomas (WHO 1-3) was considered, excluding glioblastomas.

Methods: This is a retrospective single-center analysis of 287 patients with LGG or WHO grade III cancer. The minimum requirement was the implementation of tissue securing, which made a histopathological examination possible. A comprehensive data collection was performed, which included, inter alia, the molecular characterization of the tumors (focus IDH1, 1p19q), functional outcome, tumor progression, progression free survival and the occurrence of neurological deficits postoperatively.

Results: 287 patient cases with gliomas were examined. The median age was 37 years (18–90). IDH1 mutational status could be determined in 129 cases, 68 (52.7%) of the patients had an IDH1 mutation, 61 (47.3%) the wild-type. Both groups differed significantly in the localization of tumors: While 42 of 55 tumors located in the fontal lobe were IDH1 mutated (76.4%), 22 temporal located gliomas were wild-type and only 12 were IDH1 mutated (64.7% to 35.3%), p<0.001. The situation is also remarkable when considering the 1p19q status. Of 23 temporally localized gliomas, 91.3% were uncodeleted, only 2 (8.7%) had a codeletion (p=0.005). Furthermore, a significant increase of IDH1 wild-type gliomas was observed within the patient group who showed postoperative tumor progression after 3 months of follow-up. Patients without progress had a tumor with proven IDH1 mutation in 61.9% of cases (p=0.041).

Conclusion: The two factors “tumor localization” and “molecular-genetic markers” (IDH1 and 1p19q-codeletion) are not independent of each other. This leads to the assumption that the radiologically diagnosed localization alone is likely to allow a partial conclusion to be drawn about the possible genetic profile of a glioma.