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Contrast-enhancement in supratentorial low-grade gliomas: a classic prognostic factor in the molecular age

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Abstract

Background

Contrast enhancement (CE) is found in 10–60% of low-grade gliomas. Its prognostic significance is controversial, and its correlation with IDH mutations and 1p/19q codeletion is elusive. The aim of this study is to investigate whether CE is associated with molecular characteristics of low-grade gliomas and uncover its prognostic value.

Materials and methods

All confirmed histological cases of low-grade gliomas diagnosed at our institution between years 2000–2016 were reviewed (n = 102). Spinal and brainstem localization, only-biopsied tumours with ring-like enhancement and incomplete medical records were excluded.

Results

Mean age was 42 years ( ± 13.9 years), and 63.6% were male. The median follow-up time was 79.8 months. CE was present on 25% of preoperative MRI, and 25% of patients were considered high-risk according to Pignatti score. Most were astrocytomas (67%) and 87.2% were surgically removed. IDH mutation was found in 64.6% of tumour samples, and 18.8% had a 1p/19q codeletion. No subgroup differences were observed according to CE except for presurgical performance status and postoperative chemotherapy. IDH status and 1p/19q codeletion were evenly distributed. On univariate analysis, age, size > 6 cm, CE, extent of resection, Pignatti score, IDH mutation and 1p/19q codeletion were significantly associated to OS. On multivariate analysis, only CE and IDH status were independently associated to OS. CE remained a significant prognostic factor in IDH-mutant non-codeleted tumours when analysed by tumour subtype.

Conclusion

CE in low-grade gliomas provides prognostic information in IDH-mutant non-codeleted tumours, although its meaning remains uncertain in IDH-wildtype gliomas.

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Acknowledgements

The authors would like to thank Valentí Navarro for his support on the statistical analysis of the data. This work received no financial support.

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Author notes

  1. Miguel Gil-Gil and Jordi Bruna should both be considered co-senior authors.

Authors and Affiliations

  1. Medical Oncology Department, Institut Català D’Oncologia L’Hospitalet, Barcelona, Spain

    Florian Castet, Carlos Mesia & Miguel Gil-Gil

  2. Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-Institut Català D’Oncologia L’Hospitalet, IDIBELL (Oncobell Program), Feixa Llarga s/n, 08907, Barcelona, Spain

    Florian Castet, Cristina Izquierdo, Carlos Mesia, Miguel Gil-Gil & Jordi Bruna

  3. Medical Oncology and Radiotherapy Department, Edgardo Rebagliati Martins National Hospital - EsSalud, Lima, Peru

    Enrique Alanya

  4. Pathology Department, Hospital Universitari de Bellvitge, Barcelona, Spain

    Noemi Vidal

  5. Groupe Hospitalier Est, Service de Neuro-Oncologie, Hospices Civils de Lyon, Lyon, France

    Cristina Izquierdo & François Ducray

  6. Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France

    François Ducray

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Correspondence to Jordi Bruna.

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Miguel Gil-Gil declares personal fees from Pfizer, Novartis, Roche and Daiichi; François Ducray declares personal fees from Abbvie, Novocure and BMS. The remaining authors have nothing to disclose.

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Castet, F., Alanya, E., Vidal, N. et al. Contrast-enhancement in supratentorial low-grade gliomas: a classic prognostic factor in the molecular age. J Neurooncol 143, 515–523 (2019). https://doi.org/10.1007/s11060-019-03183-2

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