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Clinical and radiographic characteristics of diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma: a single institution review

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Abstract

Purpose

Genetic analyses of gliomas have identified key molecular features that impact treatment paradigms beyond conventional histomorphology. Despite at-times lower grade histopathologic appearances, IDH-wildtype infiltrating gliomas expressing certain molecular markers behave like higher-grade tumors. For IDH-wildtype infiltrating gliomas lacking traditional features of glioblastoma, these markers form the basis for the novel diagnosis of diffuse astrocytic glioma, IDH-wildtype (wt), with molecular features of glioblastoma (GBM), WHO grade-IV (DAG-G). However, given the novelty of this approach to diagnosis, literature detailing the exact clinical, radiographic, and histopathologic findings associated with these tumors remain in development.

Methods

Data for 25 patients matching the DAG-G diagnosis were obtained from our institution’s retrospective database. Information regarding patient demographics, treatment regimens, radiographic imaging, and genetic pathology were analyzed to determine association with clinical outcomes.

Results

The initial radiographic findings, histopathology, and symptomatology of patients with DAG-G were similar to lower-grade astrocytomas (WHO grade 2/3). Overall survival (OS) and progression free survival (PFS) associated with our cohort, however, were similar to that of IDH-wt GBM, indicating a more severe clinical course than expected from other associated features (15.1 and 5.39 months respectively).

Conclusion

Despite multiple features similar to lower-grade gliomas, patients with DAG-G experience clinical courses similar to GBM. Such findings reinforce the need for biopsy and subsequent analysis of molecular features associated with any astrocytoma regardless of presenting characteristics.

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Data availability

The datasets generated during and/or analyzed during the current study are available in the supplemental data and from the corresponding author on reasonable request.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. The Medical College of Georgia at Augusta University, Augusta, GA, USA

    Dayton Grogan

  2. Department of Neurosurgery, Emory University School of Medicine, 1365 Clifton Road, Atlanta, GA, 30322, USA

    David P. Bray, Megan Cosgrove, Andrew Boucher, Andrew Erwood, Gustavo Pradilla, Edjah K. Nduom, Jeffrey J. Olson & Kimberly B. Hoang

  3. Division of Biostatistics, Medical College of Georgia at Augusta University, Augusta, GA, USA

    Daniel F. Linder

  4. Department of Pathology & Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA

    Pia Mendoza, Bryan Morales & Stewart Neill

Authors
  1. Dayton Grogan
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  2. David P. Bray
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  13. Kimberly B. Hoang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by DG and AE. The first draft of the manuscript was written by DG, DB, and MC. All other authors provided edits and comments on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kimberly B. Hoang.

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Conflict of interest

David P. Bray is partially supported by the Nell W. and William S. Elkin Research Fellowship in Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, GA and by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378 and TL1TR002382. All other authors have no relevant financial or non-financial interests to disclose.

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Grogan, D., Bray, D.P., Cosgrove, M. et al. Clinical and radiographic characteristics of diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma: a single institution review. J Neurooncol 157, 187–195 (2022). https://doi.org/10.1007/s11060-022-03961-5

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  • DOI: https://doi.org/10.1007/s11060-022-03961-5

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