KEY TAKEAWAYS
- The aim of the study was to investigate the prognostic factors and effect of surgery in adults with H3 K27M-mutated glioma.
- Surgical features of H3 K27M gliomas in adulthood were analyzed, revealing influential prognostic factors.
With their classification as a grade-4 entity in the 2016 WHO classification, H3K27M mutated gliomas emerged as an important brain cancer subtype. Previous studies emphasized its prevalence in children and young adults, emphasizing the need for adults to understand prognostic factors and surgical implications
Alice Senta Ryba and her team conducted a study that aimed to evaluate the predictors and surgical outcome of adult H3 K27M-mutated gliomas in a multicenter study.
The study included patients over the age of 18 with molecularly confirmed H3 K27M-mutated glioma diagnoses from 2016 to 2022. The researchers analyzed clinical, radiological and surgical characteristics. Prognostic factors were identified by univariate multivariate analysis.
Among the 70 patients, the overall survival (OS) was 13.6 ± 14 months with a median age of 36.1 years. Complete resection was performed in 14.3% of cases, with subtotal resection in 30% and biopsy in 54.3%.
Tumors in the telencephalon, diencephalon, or myelencephalon were associated with poorer OS, whereas those in the mesencephalon or metencephalon had a significantly longer OS (8.7 vs. 25.0 months, P= 0.007) Preoperative Karnofsky performance score ( KPS) < 80 was associated with decreased OS (4.2 vs.18 months, P= 0.02).
Furthermore, loss of ATRX, observed in 25.7% of cases, was independently associated with increased OS (31 vs. 8.3 months, P = 0.0029). Notably, patients undergoing resection did not show a survival benefit over biopsy patients (12 vs. 11 months, P=0.4006).
The analysis described the surgical features of adult H3 K27M-mutated gliomas in multiple centers. The results show that ATRX status, tumor location, and KPS significantly influence OS. Notably, resection does not confer a survival advantage over biopsy. No funding information was available.
Ryba A, Özdemir Z, Nissimov N, et al. (2024) “Insights from a Multicenter Study on Adult H3 K27M-Mutated Glioma: Surgical Resection’s Limited Influence on Overall Survival, ATRX as Molecular Prognosticator.” Neuro-Oncology, 2024;, noae061, https://doi.org/10.1093/neuonc/noae061.
