Tumor volume and calcifications as indicators for preoperative differentiation of grade II/III diffuse gliomas

• Published in: Journal of neuro-oncology Vol. 161; no. 3; pp. 555 - 562
• Main Authors: Fukuya, Yasukazu, Tamura, Manabu, Nitta, Masayuki, Saito, Taiichi, Tsuzuki, Shunsuke, Koriyama, Shunichi, Kuwano, Atsushi, Kawamata, Takakazu, Muragaki, Yoshihiro
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-02-2023; Springer Nature B.V
• Subjects: Adult; Astrocytoma; Brain cancer; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - genetics; Brain Neoplasms - surgery; Brain tumors; Central nervous system; Computed tomography; Female; Glioma; Glioma - diagnostic imaging; Glioma - genetics; Glioma - surgery; Humans; Magnetic resonance imaging; Male; Malignancy; Medicine; Medicine & Public Health; Mutants; Mutation; Neurology; Oligodendroglioma - diagnostic imaging; Oligodendroglioma - genetics; Oligodendroglioma - surgery; Oncology; Retrospective Studies; Tumor Burden; Tumors; Preoperative index; Diffuse glioma; Preoperative tumor volume; Malignancy grade
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1007/s11060-023-04244-3

Purpose
To retrospectively evaluate preoperative clinical factors for their ability to preoperatively differentiate malignancy grades in patients with incipient supratentorial grade II/III diffuse gliomas.
Methods
This retrospective study included 206 adult patients with incipient supratentorial grade II/III diffuse gliomas according to the 2016 World Health Organization classification of tumors of the central nervous system. The cohort included 136 men and 70 women, with a median age of 41 years. Preoperative factors included age, sex, presence of calcifications on computed tomography scans, and preoperative tumor volume measured using preoperative magnetic resonance imaging.
Results
In patients with oligodendrogliomas (
IDH
-mutant and 1p/19q-codeleted), calcifications were significantly more frequent (p = 0.0034) and tumor volume was significantly larger (p < 0.001) in patients with grade III tumors than in those with grade II tumors. Moreover, in patients with
IDH
-mutant astrocytomas, preoperative tumor volume was significantly larger (p = 0.0042) in patients with grade III tumors than in those with grade II tumors. In contrast, none of the evaluated preoperative clinical factors were significantly different between the patients with grade II and III
IDH
-wildtype astrocytomas.
Conclusion
In adult patients with suspicison incipient supratentorial grade II/III diffuse gliomas, presence of calcifications and larger preoperative tumor volume might be used as preoperative indices to differentiate between malignancy grades II and III in oligodendrogliomas (
IDH
-mutant and 1p/19q-codeleted) and larger preoperative tumor volume might have similar utility in
IDH
-mutant astrocytomas.