RESULTS OF TREATMENT OF ADULT PATIENTS WITH DIFFUSE GLIOMAS GRADE III—IV

Objective. To compare the treatment outcomes of adult patients with diffuse glial brain tumors grade III—IV according to their diagnostic criteria in the 2021 WHO and 2016 WHO classifications of tumors of CNS.

Materials and methods. The study included 651 patients with adult-type diffuse glial brain tumor (2021WHO CNS:
24 (3,7 %) — oligodendroglioma, IDHmut and 1p/19q-codeleted, grade III; 39 (6,0 %) — astrocytoma, IDHmut, grade III;
30 (4,6 %) — astrocytoma, IDHmut, grade IV and 558 (85,7 %) — glioblastoma, IDHwt) treated in 2017—2021. The prognostic value of the tumor category in relation to patient survival was studied.

Results. Grouping according to 2021 WHO CNS was predictive of survival for patients with astrocytoma, IDHmut, grade III (median of overall survival (OS) not achieved), astrocytoma, IDHmut, grade IV (median OS — 36,5±8,8 months, p=0,043) and glioblastoma, IDHwt (median OS — 9,6±0,6 months, p<0,001 compared to each of the above groups). In patients with oligodendroglioma (median OS not reached) and astrocytoma, IDHmut, grade III, the survival results were not statistically significantly different (p=0,356). Statistically significant differences in the survival of patients with nosological forms of the 2016 WHO CNS “Anaplastic astrocytoma, grade III, IDHwt” (median OS — 11,6±1,6 months) and “Glioblastoma grade IV, IDHwt” (median OS — 9,5±0,6 months) were also absent (p=0,610).

Conclusion. The 2021 WHO CNS quite clearly reflects the differences in group prognosis of the course of the disease among diffuse grade III—IV adult gliomas, however, to clarify the differences in survival of patients with oligodendroglioma, IDHmut and 1p/19q-codeleted, grade III and astrocytoma, IDHmut, grade III requires longer follow-up periods. A retrospective comparison of the results of treatment of patients treated before and after the adoption of the 2021 WHO CNS is possible when determining the main molecular genetic parameters of the tumor.

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Автор(ы): V. V. Sinaika, P. G. Kisialeu, A. I. Subаch, A. S. Portyanko