Article
Lower-grade gliomas show different molecular markers but not different tumour volumes in an aged population
Die molekularen Marker, nicht aber die Tumorvolumina von niedriggradigeren Gliomen unterscheiden sich in der altersspezifischen Analyse
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Authors
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Aleksandrs Krigers
- Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Austria
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Johannes Kerschbaumer
- Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Austria
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Mathias Demetz
- Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Austria
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Claudius Thomé
- Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Austria
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Christian F. Freyschlag
- Medizinische Universität Innsbruck, Universitätsklinik für Neurochirurgie, Innsbruck, Austria
| Published: | June 26, 2020 |
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Outline
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Objective: The mean age of the population is rising, and the health care system is going to deal with this tendency. The aim of our study was to find specific age-related aspects and behavioural qualities of the lower-grade gliomas.
Methods: 99 consecutive patients with histologically proven diffuse or anaplastic glioma, which underwent their first tumour resection in our institution, were retrospectively selected. The volume of MRI findings was measured in T1 CE and native, T2, Flair and DWI sequences using ITK-SNAP software. The casual neuropathological, epidemiological and clinical data was retrieved from patients’ charts.
Results: The mean age of 55 males and 44 females in our series was 45 years (SD ±16). The patients harboring more aggressive LGGs were older – 47 patients with diffuse glioma had the mean age of 38 years (SD ±14) compared to 52 patients with anaplastic gliomas, which had mean age of 50 years (SD ±16), p<0.001.
Patients with wildtype IDH1 were also older – 53 years (SD ±19) vs. 41 years (SD ±14, N=72), p=0.004. Patients with ATRX expression were older as well – 49 years (SD ±17) vs. 38 years (SD ±11) or for 12 (SE ±4) years, N=55, p=0.006.
The CE volume in T1 sequence by the time of diagnosis higher increased with age: Spearman r=0.32, N=54, p=0.015. At the same time the native volumes in the older patient group were lower: in T1 – r=-0.33, p=0.013; in T2 – r=-0.29, p=0.03, DWI – r=-0.35, p=0.09. They were significantly more often symptomatic at the time of first imaging, p=0.037; and the first resection was performed earlier – r=-0.2, p=0.05.
We did not find any significant differences in resection rate or volume with regard to age. However, the remnant absolute CE volume in T1 sequence stayed higher in older patients: r=0.22, N=75, p=0.014. The PFS in them was significantly lower, p<0.008; but the OS did not differ in Cox models.
Conclusion: The higher age correlates to negative molecular marker expression and lower PFS compared to a younger cohort, however, this could not be translated into a shorter OS.
