Clinical Management and Survival Outcomes of Patients with Different Molecular Subtypes of Diffuse Gliomas in China (2011-2017): a Multicenter Retrospective Study from CGGA

Overview

Journal Cancer Biol Med

Specialty Oncology

Date 2022 Nov 9

PMID 36350010

Authors

Kenan Zhang

Xing Liu

Guanzhang Li

Xin Chang

Shouwei Li

Jing Chen

Zheng Zhao

Jiguang Wang

Tao Jiang

Ruichao Chai

Affiliations

Soon will be listed here.

Abstract

Objective: We aimed to summarize the clinicopathological characteristics and prognostic features of various molecular subtypes of diffuse gliomas (DGs) in the Chinese population.

Methods: In total, 1,418 patients diagnosed with DG between 2011 and 2017 were classified into 5 molecular subtypes according to the 2016 WHO classification of central nervous system tumors. The IDH mutation status was determined by immunohistochemistry and/or DNA sequencing, and 1p/19q codeletion was detected with fluorescence in situ hybridization. The median clinical follow-up time was 1,076 days. T-tests and chi-square tests were used to compare clinicopathological characteristics. Kaplan-Meier and Cox regression methods were used to evaluate prognostic factors.

Results: Our cohort included 15.5% lower-grade gliomas, IDH-mutant and 1p/19q-codeleted (LGG-IDHm-1p/19q); 18.1% lower-grade gliomas, IDH-mutant (LGG-IDHm); 13.1% lower-grade gliomas, IDH-wildtype (LGG-IDHwt); 36.1% glioblastoma, IDH-wildtype (GBM-IDHwt); and 17.2% glioblastoma, IDH-mutant (GBM-IDHm). Approximately 63.3% of the enrolled primary gliomas, and the median overall survival times for LGG-IDHm, LGG-IDHwt, GBM-IDHwt, and GBM-IDHm subtypes were 75.97, 34.47, 11.57, and 15.17 months, respectively. The 5-year survival rate of LGG-IDHm-1p/19q was 76.54%. We observed a significant association between high resection rate and favorable survival outcomes across all subtypes of primary tumors. We also observed a significant role of chemotherapy in prolonging overall survival for GBM-IDHwt and GBM-IDHm, and in prolonging post-relapse survival for the 2 recurrent GBM subtypes.

Conclusions: By controlling for molecular subtypes, we found that resection rate and chemotherapy were 2 prognostic factors associated with survival outcomes in a Chinese cohort with DG.

Citing Articles

Identification and validation of TSPAN13 as a novel temozolomide resistance-related gene prognostic biomarker in glioblastoma.

Wang H, Liu Z, Peng Z, Lv P, Fu P, Jiang X PLoS One. 2025; 20(2):e0316552.

PMID: 39903772 PMC: 11793784. DOI: 10.1371/journal.pone.0316552.

Overexpression of miR-124 enhances the therapeutic benefit of TMZ treatment in the orthotopic GBM mice model by inhibition of DNA damage repair.

Wei Y, Wang P, Zhao J, Fan X, Jiang J, Mu X Cell Death Dis. 2025; 16(1):47.

PMID: 39865088 PMC: 11770086. DOI: 10.1038/s41419-025-07363-z.

Prognostic value of CTF1 in glioma and its role in the tumor microenvironment.

He J, Guo J, Sun P Transl Cancer Res. 2025; 13(12):6862-6879.

PMID: 39816535 PMC: 11730202. DOI: 10.21037/tcr-24-1258.

KL-50: A novel therapeutic agent targeting MGMT-deficient glioblastoma.

Zhang K, Touat M, Khasraw M Neuro Oncol. 2025; 27(3):652-653.

PMID: 39777476 PMC: 11889707. DOI: 10.1093/neuonc/noaf001.

SOCS1: A potential diagnostic and prognostic marker for aggressive gliomas and a new target for immunotherapy.

Gu C, Chen X, Wu J, Zhang Y, Zhong L, Luo H Medicine (Baltimore). 2024; 103(49):e40632.

PMID: 39654174 PMC: 11630960. DOI: 10.1097/MD.0000000000040632.

References

Jiang T, Nam D, Ram Z, Poon W, Wang J, Boldbaatar D . Clinical practice guidelines for the management of adult diffuse gliomas. Cancer Lett. 2020; 499:60-72. DOI: 10.1016/j.canlet.2020.10.050. View

Tan A, Ashley D, Lopez G, Malinzak M, Friedman H, Khasraw M . Management of glioblastoma: State of the art and future directions. CA Cancer J Clin. 2020; 70(4):299-312. DOI: 10.3322/caac.21613. View

Jiang T, Tang G, Lin Y, Peng X, Zhang X, Zhai X . Prevalence estimates for primary brain tumors in China: a multi-center cross-sectional study. Chin Med J (Engl). 2011; 124(17):2578-83. View

Orringer D, Lau D, Khatri S, Zamora-Berridi G, Zhang K, Wu C . Extent of resection in patients with glioblastoma: limiting factors, perception of resectability, and effect on survival. J Neurosurg. 2012; 117(5):851-9. DOI: 10.3171/2012.8.JNS12234. View

Ludwig K, Kornblum H . Molecular markers in glioma. J Neurooncol. 2017; 134(3):505-512. PMC: 5568999. DOI: 10.1007/s11060-017-2379-y. View

Eckel-Passow J, Lachance D, Molinaro A, Walsh K, Decker P, Sicotte H . Glioma Groups Based on 1p/19q, IDH, and TERT Promoter Mutations in Tumors. N Engl J Med. 2015; 372(26):2499-508. PMC: 4489704. DOI: 10.1056/NEJMoa1407279. View

Li Y, Qian Z, Xu K, Wang K, Fan X, Li S . MRI features predict p53 status in lower-grade gliomas via a machine-learning approach. Neuroimage Clin. 2018; 17:306-311. PMC: 5842645. DOI: 10.1016/j.nicl.2017.10.030. View

Singh G, Manjila S, Sakla N, True A, Wardeh A, Beig N . Radiomics and radiogenomics in gliomas: a contemporary update. Br J Cancer. 2021; 125(5):641-657. PMC: 8405677. DOI: 10.1038/s41416-021-01387-w. View

Albuquerque L, Almeida J, de Macedo Filho L, Joaquim A, Duffau H . Extent of resection in diffuse low-grade gliomas and the role of tumor molecular signature-a systematic review of the literature. Neurosurg Rev. 2020; 44(3):1371-1389. DOI: 10.1007/s10143-020-01362-8. View

10.

Louis D, Perry A, Wesseling P, Brat D, Cree I, Figarella-Branger D . The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol. 2021; 23(8):1231-1251. PMC: 8328013. DOI: 10.1093/neuonc/noab106. View

11.

Wang G, Cioffi G, Patil N, Waite K, Lanese R, Ostrom Q . Importance of the intersection of age and sex to understand variation in incidence and survival for primary malignant gliomas. Neuro Oncol. 2021; 24(2):302-310. PMC: 8804884. DOI: 10.1093/neuonc/noab199. View

12.

Alexopoulos G, Zhang J, Karampelas I, Patel M, Kemp J, Coppens J . Long-Term Time Series Forecasting and Updates on Survival Analysis of Glioblastoma Multiforme: A 1975-2018 Population-Based Study. Neuroepidemiology. 2022; 56(2):75-89. DOI: 10.1159/000522611. View

13.

Eldesouki S, Samara K, Qadri R, Obaideen A, Otour A, Habbal O . XIST in Brain Cancer. Clin Chim Acta. 2022; 531:283-290. DOI: 10.1016/j.cca.2022.04.993. View

14.

Mirza F, Shamim M . Extent of resection and timing of surgery in adult low grade glioma. J Pak Med Assoc. 2017; 67(6):959-961. View

15.

Kazerooni A, Bakas S, Saligheh Rad H, Davatzikos C . Imaging signatures of glioblastoma molecular characteristics: A radiogenomics review. J Magn Reson Imaging. 2019; 52(1):54-69. PMC: 7457548. DOI: 10.1002/jmri.26907. View

16.

Ostrom Q, Shoaf M, Cioffi G, Waite K, Kruchko C, Wen P . National-level overall survival patterns for molecularly-defined diffuse glioma types in the United States. Neuro Oncol. 2022; 25(4):799-807. PMC: 10076944. DOI: 10.1093/neuonc/noac198. View

17.

Liu J, Li C, Wang Y, Ji P, Guo S, Zhai Y . Prognostic and Predictive Factors in Elderly Patients With Glioblastoma: A Single-Center Retrospective Study. Front Aging Neurosci. 2022; 13:777962. PMC: 8841486. DOI: 10.3389/fnagi.2021.777962. View

18.

Karschnia P, Vogelbaum M, van den Bent M, Cahill D, Bello L, Narita Y . Evidence-based recommendations on categories for extent of resection in diffuse glioma. Eur J Cancer. 2021; 149:23-33. DOI: 10.1016/j.ejca.2021.03.002. View

19.

Chai R, Zhang K, Chang Y, Wu F, Liu Y, Zhao Z . Systematically characterize the clinical and biological significances of 1p19q genes in 1p/19q non-codeletion glioma. Carcinogenesis. 2019; 40(10):1229-1239. DOI: 10.1093/carcin/bgz102. View

20.

Li S, Qiu X, Chen B, Zhang W, Ren H, Wang Z . Prognostic factors influencing clinical outcomes of glioblastoma multiforme. Chin Med J (Engl). 2009; 122(11):1245-9. View