Turkish Neurosurgery 2022 , Vol 32 , Num 3
Analysis of the Prognosis of High-Grade gliomas in the View of New Immunohistochemistry Markers and 2016 WHO Classification
Duygu DOLEN1,Tural AHMADOV1,Ilyas DOLAS1,Tugrul Cem UNAL1,Aydın AYDOSELI1,Metehan OZTURK1,Pulat Akin SABANCI1,Yavuz ARAS1,Mebrure Bilge BILGIC2,Altay SENCER1
1Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey
2Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.40005-22.2 AIM: To evaluate isocitrate dehydrogenase (IDH) mutation status and Ki67 percentages of tumors that were treated in our institution to determine whether these markers affected the initial diagnosis and survival rates.

MATERIAL and METHODS: High-grade glioma patients, who were operated in our department between 2013 and 2018, were enrolled in the study and retrospectively reviewed. New immunohistochemistry staining studies were conducted and survival analyses were performed.

RESULTS: Of 135 patients and 136 tumors, 117 were glioblastoma multiforme (GBM), 8 were grade III-IV glioma, 4 were anaplastic astrocytoma and 7 were anaplastic oligodendroglioma. One patient had two different lesions, which were GBM and anaplastic astrocytoma respectively. Mean age was 55 (7-85) years, and 88 (65%) were male and 47 (35%) were female. The most common complaint was motor deficit (56%). Fourteen patients underwent reoperation due to recurrent disease. Tumors were most commonly found in the frontal lobe (53, 39%). Magnetic resonance imaging (MRI) features showed that existence of necrosis is strongly related to GBM (p<0.01). Approximately 126 patients were found to be IDH-wildtype, which changed 6 patients? diagnosis to GBM, IDH wildtype from grade III-IV glioma. Five patients, who were diagnosed with anaplastic astrocytoma and anaplastic oligodendroglioma initially were found to be IDH wildtype. IDH mutation status, extend of resection, and age were found to affect survival.

CONCLUSION: IDH mutation status is important in classifying high-grade gliomas, as well as its effects on prognosis. This mutation is related to several radiological features of tumors. Extent of resection and patient age are also profoundly affect survival. Detailing the diagnosis with molecular features will help physicians to shape targeted adjuvant therapies, which would better outcomes. Keywords : High-grade gliomas, Neuropathology, WHO Classification, Integrated diagnoses, Neurooncology

Corresponding author : Duygu DOLEN, dolenduygu@gmail.com