Scholarlink

Introduction <p>The predictors and prognostic implications of malignant transformation (MT) in IDH-mutant gliomas remain incompletely defined. Prior studies have often included mixed IDH populations or relied on contrast enhancement as a surrogate for transformation, which is an unreliable marker of malignant progression.</p> Methods <p>We retrospectively reviewed patients with recurrent IDH-mutant gliomas who underwent multiple surgical resections between 2009 and 2024 at a single tertiary center. Malignant transformation was defined as a pathologically confirmed increase in tumor grade between the initial and any subsequent surgery.</p> Results <p>Among 124 patients identified, 73 (58.9%) experienced malignant transformation. Transformation patterns included grade 2–3 astrocytomas (19.4%), grade 2–3 oligodendrogliomas (18.9%), grade 3–4 astrocytomas (12.1%), and grade 2–4 astrocytomas (8.9%). Median time to transformation was 6.2 years for grade 2–3 astrocytomas, 8.8 years for grade 2–3 oligodendrogliomas, 5.7 years for grade 3–4 astrocytomas, and 4.3 years for grade 2–4 astrocytomas (<i>p</i> = 0.42). Malignant transformation was associated with significantly shorter progression-free survival (1.1 vs. 4.4 years; <i>p</i> &lt; 0.0001) and overall survival following transformation (1.7 vs. 5.8 years; <i>p</i> &lt; 0.0001). On multivariable analysis, 1p/19q codeletion (HR 0.35, 95% CI 0.20–0.62) and adjuvant radiotherapy (HR 0.48, 95% CI 0.27–0.83) were associated with reduced risk of transformation, whereas subventricular zone involvement was associated with increased risk (HR 1.9, 95% CI 1.01–3.58).</p> Conclusion <p>These findings refine current understanding of the timing, risk factors, and prognostic impact of malignant transformation in IDH-mutant gliomas and underscore the need for molecularly informed strategies to improve risk stratification and guide targeted interventions.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Malignant transformation in IDH-mutant gliomas: clinical drivers and survival outcomes in a histologically defined cohort

  • 期刊论文

  • 发表日期：

    2026年3月10日

查看全文
  • Neslihan Nisa Gecici,
  • Amelia Stepniak,
  • Kenan Kerem Ozcinar,
  • Ahmed Habib,
  • Maged T. Ghoche,
  • Kalil G. Abdullah,
  • Pascal O. Zinn

摘要

Introduction

The predictors and prognostic implications of malignant transformation (MT) in IDH-mutant gliomas remain incompletely defined. Prior studies have often included mixed IDH populations or relied on contrast enhancement as a surrogate for transformation, which is an unreliable marker of malignant progression.

Methods

We retrospectively reviewed patients with recurrent IDH-mutant gliomas who underwent multiple surgical resections between 2009 and 2024 at a single tertiary center. Malignant transformation was defined as a pathologically confirmed increase in tumor grade between the initial and any subsequent surgery.

Results

Among 124 patients identified, 73 (58.9%) experienced malignant transformation. Transformation patterns included grade 2–3 astrocytomas (19.4%), grade 2–3 oligodendrogliomas (18.9%), grade 3–4 astrocytomas (12.1%), and grade 2–4 astrocytomas (8.9%). Median time to transformation was 6.2 years for grade 2–3 astrocytomas, 8.8 years for grade 2–3 oligodendrogliomas, 5.7 years for grade 3–4 astrocytomas, and 4.3 years for grade 2–4 astrocytomas (p = 0.42). Malignant transformation was associated with significantly shorter progression-free survival (1.1 vs. 4.4 years; p < 0.0001) and overall survival following transformation (1.7 vs. 5.8 years; p < 0.0001). On multivariable analysis, 1p/19q codeletion (HR 0.35, 95% CI 0.20–0.62) and adjuvant radiotherapy (HR 0.48, 95% CI 0.27–0.83) were associated with reduced risk of transformation, whereas subventricular zone involvement was associated with increased risk (HR 1.9, 95% CI 1.01–3.58).

Conclusion

These findings refine current understanding of the timing, risk factors, and prognostic impact of malignant transformation in IDH-mutant gliomas and underscore the need for molecularly informed strategies to improve risk stratification and guide targeted interventions.