Adult infiltrating gliomas with WHO 2016 integrated diagnosis: additional prognostic roles of ATRX and TERT

AbstractThe “integrated diagnosis” for infiltrating gliomas in the 2016 revised World Health Organization (WHO) classification of tumors of the central nervous system requires assessment of the tumor forIDH mutations and 1p/19q codeletion. SinceTERT promoter mutations and ATRX alterations have been shown to be associated with prognosis, we analyzed whether these tumor markers provide additional prognostic information within each of the five WHO 2016 categories. We used data for 1206 patients from the UCSF Adult Glioma Study, the Mayo Clinic and The Cancer Genome Atlas (TCGA) with infiltrative glioma, grades II-IV for whom tumor status forIDH, 1p/19q codeletion, ATRX, andTERT had been determined. All cases were assigned to one of 5 groups following the WHO 2016 diagnostic criteria based on their morphologic features, andIDH and 1p/19q codeletion status. These groups are: (1) Oligodendroglioma,IDH-mutant and 1p/19q-codeleted; (2) Astrocytoma,IDH-mutant; (3) Glioblastoma,IDH-mutant; (4) Glioblastoma,IDH-wildtype; and (5) Astrocytoma,IDH-wildtype. Within each group, we used univariate and multivariate Cox proportional hazards models to assess associations of overall survival with patient age at diagnosis, grade, and ATRX alteration status and/orTERT promoter mutation status. Among Group 1IDH-mutant 1p/19q-codeleted oligodendrogliomas, theTERT-WT group had significantly worse overall survival than theTERT-MUT group (HR: 2.72, 95% CI 1.05 –7.04,p = 0.04). In both Group 2,ID...
Source: Acta Neuropathologica - Category: Neurology Source Type: research