Purpose: IDH-mutant glioma are classified as oligodendroglioma or astrocytoma on the basis of 1p19q-codeletion. Whether prognostic factors are similar between these tumor types is not well understood. Experimental Design: Retrospective cohort study. Molecular characterization was performed with targeted next-generation sequencing. Tumor volumes were calculated using semi-automatic 3D segmentation on all pre- and postoperative MRI-scans. Overall survival was assessed with Cox proportional hazards model. Results: 383 patients with newly diagnosed IDH-mutant glioma were followed-up for a median of 7.2 years. Grade 3 and grade 4 patients had significantly lower Karnofsky performance, with tumors having more contrast-enhancement. Patients also received more aggressive post-surgery treatment. Postoperative tumor volume is significantly and independently associated with survival (HR per cm3 1.19, 95% CI 1.03 – 1.39) in IDH-mutant glioma. Separate analysis of oligodendroglioma and astrocytoma showed a significant association of postoperative tumor volume in astrocytoma, but not in oligodendroglioma. Higher age and histological tumor grade were associated with worse survival in patients with oligodendroglioma, but not with astrocytoma. Conclusions: Our data support an initial strategy of extensive resection in both oligodendroglioma and astrocytoma patients. Other important prognostic factors differ between these tumor types, urging researchers and clinicians to keep treating these tumors as separate entities.

中文翻译：

---

星形细胞瘤 IDHmt 和少突胶质细胞瘤之间年龄、切除范围和肿瘤分级的预后作用差异：单中心队列研究


目的：IDH 突变型胶质瘤根据 1p19q 编码缺失被分类为少突胶质细胞瘤或星形细胞瘤。这些肿瘤类型之间的预后因素是否相似尚不清楚。实验设计：回顾性队列研究。通过靶向下一代测序进行分子表征。在所有术前和术后 MRI 扫描中使用半自动 3D 分割计算肿瘤体积。使用 Cox 比例风险模型评估总体生存率。结果：383 名新诊断的 IDH 突变胶质瘤患者接受了中位随访 7.2 年。 3级和4级患者的卡诺夫斯基表现明显较低，肿瘤具有更多的对比度增强。患者还接受了更积极的术后治疗。 IDH 突变神经胶质瘤的术后肿瘤体积与生存率显着且独立相关（HR 每 cm3 1.19，95% CI 1.03 – 1.39）。对少突胶质细胞瘤和星形细胞瘤的单独分析显示，星形细胞瘤术后肿瘤体积显着相关，但少突胶质细胞瘤则不然。年龄和肿瘤组织学分级较高与少突胶质细胞瘤患者的生存率较差相关，但与星形细胞瘤患者的生存率无关。结论：我们的数据支持少突胶质细胞瘤和星形细胞瘤患者广泛切除的初步策略。这些肿瘤类型之间的其他重要预后因素也有所不同，这促使研究人员和临床医生继续将这些肿瘤作为单独的实体进行治疗。