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Joint-Meeting of the German Society for Neuropathology and Neuroanatomy (DGNN) and the Scandinavian Neuropathological Society (SNS)

German Society for Neuropathology and Neuroanatomy

22.09.-24.09.2016, Hamburg

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Prognostic value of contrast enhancement and histopathological grading in diffuse gliomas depends on IDH1/2 mutation

Meeting Abstract

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  • Bogdana Suchorska - Ludwigs-Maximilians-Universität, München, Germany
  • Annamaria Biczok - Ludwigs-Maximilians-Universität, München, Germany
  • Markus Lenski - Ludwigs-Maximilians-Universität, München, Germany
  • Nathalie Albert - Ludwigs-Maximilians-Universität, München, Germany
  • Jörg-Christian Tonn - Ludwigs-Maximilians-Universität, München, Germany
  • presenting/speaker Ulrich Schüller - Ludwigs-Maximilians-Universität, München, Germany

Deutsche Gesellschaft für Neuropathologie und Neuroanatomie. Scandinavian Neuropathological Society. Joint-Meeting of the German Society for Neuropathology and Neuroanatomy (DGNN) and the Scandinavian Neuropathological Society (SNS). Hamburg, 22.-24.09.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgnnP31

doi: 10.3205/16dgnn35, urn:nbn:de:0183-16dgnn359

Published: September 14, 2016

© 2016 Suchorska 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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Contrast enhancement (CE) and anaplasia have been reported to indicate poor outcome in diffuse glioma. Recently, mutational status of the IDH1/2 gene and loss of heterozygosity on chromosome 1p/19q (LOH1p/19q) have gained relevance for the evaluation of clinical outcome. We therefore aimed at assessing the value of CE and histopathological grading within this framework of molecular markers. 332 patients with grade II (n=189) or grade III diffuse glioma (n=143) were stratified into 3 groups: IDH1/2 wild type (n=118), IDH1/2 mutated with (n=123) and without (n=91) LOH1p/19q. Preoperative magnetic resonance (MR) imaging was reviewed for CE. Univariate and multivariate analyses were conducted using molecular and imaging factors as well as age, Karnofsky performance status, surgical procedure and adjuvant therapy. In the multivariate analysis, histopathological grading had a strong independent prognostic value on OS in IDH1/2 wild type tumors (p=0.001). Conversely, CE does not predict overall survival in IDH1/2 wild type tumors. In gliomas with IDH1/2 mutation, CE independently predicts survival (p=0.04) and this effect seems to be especially pronounced in the IDH1/2 mutated group without LOH 1p/19q. In patients with diffuse gliomas WHO grade II/III and IDH1/2 wildtype, CE is not associated with survival in contrast to grading. In patients with an IDH1/2 mutation, presence of CE on initial MRI is linked to inferior survival, while grading is not.