Determinants of long-term survival in patients with IDH-mutant gliomas

Katzendobler, Sophie; Niedermeyer, Sebastian ; Blobner, Jens; Trumm, Christoph ; Harter, Patrick N.; Baumgarten, Louisa von ; Stoecklein, Veit M.; Tonn, Joerg-Christian; Weller, Michael ; Thon, Niklas und Weller, Jonathan (24. September 2024): Determinants of long-term survival in patients with IDH-mutant gliomas. In: Journal of Neuro-Oncology, Bd. 170: S. 655-664

Abstract

Background

Survival times of patients with IDH-mutant gliomas are variable and can extend to decades. Many studies provide progression-free rather than overall survival times and prognostic factors remain ill-defined. Here we explored characteristics of short- and long-term survivors within a cohort of patients with extended follow-up.

Methods

This single-center, case-control study included 86 patients diagnosed between 1998 and 2023 who either died within 6 years after diagnosis or survived at least 15 years. Patient characteristics and prognostic factors were stratified by short- (< 6 years) versus long-term (≥ 15 years) survival.

Results

Forty-seven patients (55%) diagnosed with astrocytoma and 39 patients (45%) with oligodendroglioma were included retrospectively. Median follow-up of the survivors was 16.6 years (range 15-28.9). Thirty-four deaths (40%) had been reported at database closure. Long-term survival was associated with CNS WHO grade 2 (p < 0.01), smaller tumor volumes (p = 0.01), lack of contrast enhancement (p < 0.01), wait-and-scan strategies (p < 0.01) and female sex (p = 0.04). In multivariate analyses for oligodendroglioma, larger T2 tumor volumes were associated with shorter survival (HR 1.02; 95% CI 1.01–1.05; p = 0.04). In patients with astrocytoma, lack of contrast enhancement (HR 0.38; 95% CI 0.15–0.94; p = 0.04) and wait-and-scan strategies (HR 5.75; 95% CI 1.66–26.61; p = 0.01) were associated with longer survival.

Conclusion

Large T2 tumor volume and contrast enhancement may be important risk factors for shorter survival, while age might be of lesser importance. Wait-and-scan strategies may yield excellent long-term survival in some patients with astrocytoma.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Klinikum der LMU München > Neurochirurgische Klinik und Poliklinik
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0167-594X
• Sprache: Englisch