Histological and molecular glioblastoma, IDH-wildtype: a real-world landscape using the 2021 WHO classification of central nervous system tumors

• DOI: 10.3389/fonc.2023.1200815
• Publication Date: 2023-07-06T14:36:55Z
• Authors: Xiaopeng Guo; Lingui Gu; Yilin Li; Zhiyao Zheng; Wenlin Chen; Yaning Wang; Yuekun Wang; Hao Xing; Yixin Shi; Delin Liu; Tianrui Yang; Yu Xia; Junlin Li; Jiaming Wu; Kun Zhang; Tingyu Liang; Hai Wang; Qianshu Liu; Shanmu Jin; Tian Qu; Siying Guo; Huanzhang Li; Yu Wang; Wenbin Ma
• Keywords: Brain tumor

Glioblastoma (GBM), the most lethal primary brain malignancy, is divided into histological (hist-GBM) and molecular (mol-GBM) subtypes according to 2021 World Health Organization classification of central nervous system tumors. This study aimed characterize clinical, radiological, molecular, survival features GBM under current scheme explore determinants.We re-examined genetic alterations IDH-wildtype diffuse gliomas at our institute from 2011 2022, enrolled GBMs for analysis after re-classification. Univariable multivariable analyses were used identify determinants.Among 209 gliomas, 191 GBMs, including 146 hist-GBMs (76%) 45 mol-GBMs (24%). Patients with younger, less likely develop preoperative motor dysfunction, more epilepsy than hist-GBMs. Mol-GBMs exhibited lower radiographic incidences contrast enhancement intratumoral necrosis. Common included copy-number changes in chromosomes 1, 7, 9, 10, 19, as well EGFR, TERT, CDKN2A/B, PTEN, distinct patterns observed between two subtypes. The median overall (mOS) GMB was 12.6 months. had a higher mOS hist-GBMs, although not statistically significant (15.6 vs. 11.4 months, p=0.17). Older age, male sex, tumor involvement deep structure or functional area, CDK4, CDK6, CIC, FGFR3, KMT5B, MYB predictors worse prognosis, while MGMT promoter methylation, maximal resection, treatment based on Stupp protocol predictive better survival.The definition its prognostic characteristics have been altered classification.