Recurrence patterns after maximal surgical resection and postoperative radiotherapy in anaplastic gliomas according to the new 2016 WHO classification

Jung Ho Im, Je Beom Hong, SeHoon Kim, Junjeong Choi, Jong Hee Chang, Jaeho Cho, Chang-Ok Suh

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Abstract

We assessed the appropriateness of current radiotherapy volume for WHO grade III gliomas. The records of 73 patients with WHO grade III gliomas who received postoperative radiotherapy between 2001 and 2013 were retrospectively reviewed. Based on the 2016 WHO classification, 25/73 (34.2%) patients had anaplastic oligodendroglioma (AO), IDH-mutant and 1p/19q-codeleted; 11/73 (15.1%) patients had anaplastic astrocytoma, IDH-mutant; and 37/73 (50.7%) patients had anaplastic astrocytoma, IDH-wildtype. The extent of resection (EOR) was total in 43 patients (58.9%). The median follow-up time was 84 months. The 5-year overall survival was 65.4%. Of 31 patients with documented recurrences, 20 (64.5%) had infield gross tumor volume (GTV) failure, six (19.4%) had clinical target volume (CTV)/marginal failure, and five (16.1%) had outfield failure/seeding. In 13 recurrences among 43 patients who underwent gross total resection (GTR), six (46.2%) had infield CTV/marginal failure. However, among 30 patients for whom GTR was not conducted, infield GTV failure was dominant (77.8%). Seventeen patients with AO, IDH-mutant and 1p/19q-codeleted who underwent GTR experienced no recurrence. In conclusion, maximal surgical resection and postoperative radiotherapy resulted in a favorable prognosis, especially in patients with GTR, IDH mutation, and 1p/19q codeletion. Patterns of failure differed by EOR.

Original languageEnglish
Article number777
JournalScientific reports
Volume8
Issue number1
DOIs
Publication statusPublished - 2018 Dec 1

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Glioma
Radiotherapy
Recurrence
Oligodendroglioma
Astrocytoma
Tumor Burden
Mutation
Survival

All Science Journal Classification (ASJC) codes

  • General

Cite this

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title = "Recurrence patterns after maximal surgical resection and postoperative radiotherapy in anaplastic gliomas according to the new 2016 WHO classification",
abstract = "We assessed the appropriateness of current radiotherapy volume for WHO grade III gliomas. The records of 73 patients with WHO grade III gliomas who received postoperative radiotherapy between 2001 and 2013 were retrospectively reviewed. Based on the 2016 WHO classification, 25/73 (34.2{\%}) patients had anaplastic oligodendroglioma (AO), IDH-mutant and 1p/19q-codeleted; 11/73 (15.1{\%}) patients had anaplastic astrocytoma, IDH-mutant; and 37/73 (50.7{\%}) patients had anaplastic astrocytoma, IDH-wildtype. The extent of resection (EOR) was total in 43 patients (58.9{\%}). The median follow-up time was 84 months. The 5-year overall survival was 65.4{\%}. Of 31 patients with documented recurrences, 20 (64.5{\%}) had infield gross tumor volume (GTV) failure, six (19.4{\%}) had clinical target volume (CTV)/marginal failure, and five (16.1{\%}) had outfield failure/seeding. In 13 recurrences among 43 patients who underwent gross total resection (GTR), six (46.2{\%}) had infield CTV/marginal failure. However, among 30 patients for whom GTR was not conducted, infield GTV failure was dominant (77.8{\%}). Seventeen patients with AO, IDH-mutant and 1p/19q-codeleted who underwent GTR experienced no recurrence. In conclusion, maximal surgical resection and postoperative radiotherapy resulted in a favorable prognosis, especially in patients with GTR, IDH mutation, and 1p/19q codeletion. Patterns of failure differed by EOR.",
author = "Im, {Jung Ho} and Hong, {Je Beom} and SeHoon Kim and Junjeong Choi and Chang, {Jong Hee} and Jaeho Cho and Chang-Ok Suh",
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AU - Im, Jung Ho

AU - Hong, Je Beom

AU - Kim, SeHoon

AU - Choi, Junjeong

AU - Chang, Jong Hee

AU - Cho, Jaeho

AU - Suh, Chang-Ok

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N2 - We assessed the appropriateness of current radiotherapy volume for WHO grade III gliomas. The records of 73 patients with WHO grade III gliomas who received postoperative radiotherapy between 2001 and 2013 were retrospectively reviewed. Based on the 2016 WHO classification, 25/73 (34.2%) patients had anaplastic oligodendroglioma (AO), IDH-mutant and 1p/19q-codeleted; 11/73 (15.1%) patients had anaplastic astrocytoma, IDH-mutant; and 37/73 (50.7%) patients had anaplastic astrocytoma, IDH-wildtype. The extent of resection (EOR) was total in 43 patients (58.9%). The median follow-up time was 84 months. The 5-year overall survival was 65.4%. Of 31 patients with documented recurrences, 20 (64.5%) had infield gross tumor volume (GTV) failure, six (19.4%) had clinical target volume (CTV)/marginal failure, and five (16.1%) had outfield failure/seeding. In 13 recurrences among 43 patients who underwent gross total resection (GTR), six (46.2%) had infield CTV/marginal failure. However, among 30 patients for whom GTR was not conducted, infield GTV failure was dominant (77.8%). Seventeen patients with AO, IDH-mutant and 1p/19q-codeleted who underwent GTR experienced no recurrence. In conclusion, maximal surgical resection and postoperative radiotherapy resulted in a favorable prognosis, especially in patients with GTR, IDH mutation, and 1p/19q codeletion. Patterns of failure differed by EOR.

AB - We assessed the appropriateness of current radiotherapy volume for WHO grade III gliomas. The records of 73 patients with WHO grade III gliomas who received postoperative radiotherapy between 2001 and 2013 were retrospectively reviewed. Based on the 2016 WHO classification, 25/73 (34.2%) patients had anaplastic oligodendroglioma (AO), IDH-mutant and 1p/19q-codeleted; 11/73 (15.1%) patients had anaplastic astrocytoma, IDH-mutant; and 37/73 (50.7%) patients had anaplastic astrocytoma, IDH-wildtype. The extent of resection (EOR) was total in 43 patients (58.9%). The median follow-up time was 84 months. The 5-year overall survival was 65.4%. Of 31 patients with documented recurrences, 20 (64.5%) had infield gross tumor volume (GTV) failure, six (19.4%) had clinical target volume (CTV)/marginal failure, and five (16.1%) had outfield failure/seeding. In 13 recurrences among 43 patients who underwent gross total resection (GTR), six (46.2%) had infield CTV/marginal failure. However, among 30 patients for whom GTR was not conducted, infield GTV failure was dominant (77.8%). Seventeen patients with AO, IDH-mutant and 1p/19q-codeleted who underwent GTR experienced no recurrence. In conclusion, maximal surgical resection and postoperative radiotherapy resulted in a favorable prognosis, especially in patients with GTR, IDH mutation, and 1p/19q codeletion. Patterns of failure differed by EOR.

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