Gliomas Diagnostic Criteria and Prognosis
38 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

In IDH-mutant and 1p/19q-codeleted oligodendrogliomas, what is associated with shorter PFS and OS?

  • Low mitotic count (< 2.5 mitoses/mm^2^)
  • Presence of necrosis
  • High mitotic count (≥ 2.5 mitoses/mm^2^) (correct)
  • Absence of microvascular proliferation

    • What is a significant prognostic factor in cases lacking CDKN2A homozygous deletion?

  • High mitotic count
  • Microvascular proliferation and/or necrosis (correct)
  • 1p/19q codeletion
  • IDH mutation

    • What is an independent predictor of survival for patients with oligodendroglial tumours in older studies?

  • Mitotic count
  • CNS WHO grade (correct)
  • IDH mutation
  • 1p/19q codeletion

    • In patients with gliomas with concurrent IDH mutation and TERT promoter mutation, what is associated with longer survival times?

    <p>Grade 2 tumours</p> Signup and view all the answers

    What is associated with shorter OS in patients with IDH-mutant and 1p/19q-codeleted oligodendrogliomas?

    <p>CNS WHO grade 3</p> Signup and view all the answers

    What percentage of older histological series correspond to IDH-mutant and 1p/19q-codeleted oligodendrogliomas?

    <p>30-80%</p> Signup and view all the answers

    What is the median survival time of patients with CNS WHO grade 3 IDH-mutant and 1p/19q-codeleted oligodendroglioma treated with radiotherapy and PCV chemotherapy?

    <p>≥ 14 years</p> Signup and view all the answers

    What is the typical pattern of recurrence in oligodendrogliomas?

    <p>Local recurrence with occasional leptomeningeal spread</p> Signup and view all the answers

    What is a clinical factor associated with a more favourable outcome in oligodendroglioma?

    <p>Presentation with seizures</p> Signup and view all the answers

    What is the significance of IDH mutation and 1p/19q codeletion in oligodendrogliomas?

    <p>Associated with favourable response to therapy and longer survival</p> Signup and view all the answers

    What is the characteristic of malignant progression in oligodendroglioma compared to IDH-mutant astrocytoma?

    <p>Slower progression in oligodendroglioma</p> Signup and view all the answers

    What is the predictive value of higher tumour mutation burden in patients with IDH-mutant gliomas?

    <p>Shorter survival</p> Signup and view all the answers

    Which genetic mutation is associated with poor prognosis in oligodendrogliomas?

    <p>CIC mutation</p> Signup and view all the answers

    What is the impact of CDK4 amplification on outcome in oligodendrogliomas?

    <p>No impact on outcome</p> Signup and view all the answers

    What is the typical treatment approach for patients with IDH-mutant and 1p/19q-codeleted oligodendrogliomas of CNS WHO grade 2?

    <p>Deferred radiotherapy and chemotherapy until tumour progression</p> Signup and view all the answers

    What is the outcome of the EORTC 22845 trial in patients with progressive CNS WHO grade 2 gliomas?

    <p>Radiotherapy prolonged PFS but not OS</p> Signup and view all the answers

    What is the benefit of radiotherapy plus PCV chemotherapy in patients with CNS WHO grade 3 oligodendrogliomas?

    <p>Improved OS</p> Signup and view all the answers

    What is the genetic hallmark of oligodendrogliomas?

    <p>1p/19q codeletion</p> Signup and view all the answers

    What is the primary concern with therapy in patients with IDH-mutant oligodendrogliomas?

    <p>Therapy-associated neurotoxicity</p> Signup and view all the answers

    What is associated with shorter PFS and OS in IDH-mutant and 1p/19q-codeleted CNS WHO grade 3 oligodendrogliomas?

    <p>High mitotic count</p> Signup and view all the answers

    In cases lacking CDKN2A homozygous deletion, what is of prognostic significance?

    <p>Presence of microvascular proliferation and/or necrosis</p> Signup and view all the answers

    What is associated with longer survival times in patients with gliomas with concurrent IDH mutation and TERT promoter mutation?

    <p>Grade 2 tumours</p> Signup and view all the answers

    What is an independent predictor of survival for patients with oligodendroglial tumors in older studies?

    <p>CNS WHO grade</p> Signup and view all the answers

    In patients with IDH-mutant and 1p/19q-codeleted oligodendrogliomas, what is associated with shorter OS?

    <p>CNS WHO grade 3</p> Signup and view all the answers

    What is the significance of CNS WHO grade in patients with IDH-mutant and 1p/19q-codeleted oligodendrogliomas?

    <p>It is an independent predictor of survival</p> Signup and view all the answers

    What is associated with favourable response to therapy and median survival times of > 10 years in oligodendrogliomas?

    <p>IDH-mutant and 1p/19q-codeleted oligodendrogliomas</p> Signup and view all the answers

    What is the characteristic pattern of recurrence in oligodendrogliomas?

    <p>Local recurrence with rare malignant progression</p> Signup and view all the answers

    What is a clinical factor associated with a more favourable outcome in oligodendrogliomas?

    <p>Presentation with seizures</p> Signup and view all the answers

    What is the significance of IDH mutation and 1p/19q codeletion in oligodendrogliomas?

    <p>They are characteristic genetic hallmarks of oligodendrogliomas</p> Signup and view all the answers

    What percentage of older histological series correspond to IDH-mutant and 1p/19q-codeleted oligodendrogliomas?

    <p>30-80%</p> Signup and view all the answers

    How does the malignant progression in oligodendrogliomas compare to IDH-mutant astrocytoma?

    <p>It takes longer in oligodendrogliomas</p> Signup and view all the answers

    What is associated with shorter survival in patients with IDH-mutant gliomas, including oligodendrogliomas?

    <p>Higher tumour mutation burden</p> Signup and view all the answers

    What is the significance of CIC mutation in oligodendrogliomas?

    <p>It is a marker of poor prognosis</p> Signup and view all the answers

    What is the typical treatment approach for patients with IDH-mutant and 1p/19q-codeleted oligodendrogliomas of CNS WHO grade 2?

    <p>Deferred radiotherapy and chemotherapy until tumour progression</p> Signup and view all the answers

    What is the outcome of the EORTC 22845 trial in patients with progressive CNS WHO grade 2 gliomas?

    <p>Adjuvant radiotherapy prolonged PFS but not OS</p> Signup and view all the answers

    What is the benefit of radiotherapy plus PCV chemotherapy in patients with CNS WHO grade 3 oligodendrogliomas?

    <p>It improves OS but not PFS</p> Signup and view all the answers

    What is the primary concern with therapy in patients with IDH-mutant oligodendrogliomas?

    <p>Therapy-associated neurotoxicity</p> Signup and view all the answers

    What is the impact of RB1 homozygous deletion on outcome in oligodendrogliomas?

    <p>It has no impact on outcome</p> Signup and view all the answers

    Study Notes

    Staging and Prognosis

    • IDH-mutant and 1p/19q-codeleted oligodendrogliomas are associated with favourable response to therapy and median survival times of > 10 years.
    • Patients with CNS WHO grade 3 IDH-mutant and 1p/19q-codeleted oligodendroglioma who participated in prospective clinical trials and were treated with a combination of radiotherapy and procarbazine, lomustine, and vincristine (PCV) chemotherapy showed a median survival of ≥ 14 years.

    Prognostic Factors

    • Younger patient age at diagnosis, frontal lobe location, presentation with seizures, high postoperative Karnofsky score, and macroscopically complete surgical removal are associated with a more favourable outcome.
    • High mitotic count (≥ 2.5 mitoses/mm^2) is linked to shorter PFS and OS in IDH-mutant and 1p/19q-codeleted CNS WHO grade 3 oligodendrogliomas.
    • The presence of microvascular proliferation and/or necrosis is of prognostic significance in cases lacking CDKN2A homozygous deletion.

    CNS WHO Grading

    • Older studies reported CNS WHO grade as an independent predictor of survival for patients with oligodendroglial tumours.
    • Recent studies have shown that patients with grade 2 tumours had longer survival times than those with grade 3 tumours.

    Treatment

    • The optimal postoperative treatment of patients with IDH-mutant and 1p/19q-codeleted oligodendrogliomas of CNS WHO grade 2 is a matter of ongoing discussion.
    • Radiotherapy and chemotherapy are often deferred until tumour progression in patients with CNS WHO grade 2 tumours.
    • Patients with symptomatic and progressive tumours, with CNS WHO grade 3 tumours, or with large residual tumours after surgery usually receive immediate further treatment with radiotherapy and/or chemotherapy.
    • Adjuvant radiotherapy prolonged PFS but not OS in patients with progressive CNS WHO grade 2 gliomas.
    • Long-term follow-up data from randomized trials showed a major increase in OS after radiotherapy plus PCV chemotherapy in patients with CNS WHO grade 3 oligodendrogliomas.

    Staging and Prognosis

    • IDH-mutant and 1p/19q-codeleted oligodendrogliomas are associated with favourable response to therapy and median survival times of > 10 years.
    • Patients with CNS WHO grade 3 IDH-mutant and 1p/19q-codeleted oligodendroglioma who participated in prospective clinical trials and were treated with a combination of radiotherapy and procarbazine, lomustine, and vincristine (PCV) chemotherapy showed a median survival of ≥ 14 years.

    Prognostic Factors

    • Younger patient age at diagnosis, frontal lobe location, presentation with seizures, high postoperative Karnofsky score, and macroscopically complete surgical removal are associated with a more favourable outcome.
    • High mitotic count (≥ 2.5 mitoses/mm^2) is linked to shorter PFS and OS in IDH-mutant and 1p/19q-codeleted CNS WHO grade 3 oligodendrogliomas.
    • The presence of microvascular proliferation and/or necrosis is of prognostic significance in cases lacking CDKN2A homozygous deletion.

    CNS WHO Grading

    • Older studies reported CNS WHO grade as an independent predictor of survival for patients with oligodendroglial tumours.
    • Recent studies have shown that patients with grade 2 tumours had longer survival times than those with grade 3 tumours.

    Treatment

    • The optimal postoperative treatment of patients with IDH-mutant and 1p/19q-codeleted oligodendrogliomas of CNS WHO grade 2 is a matter of ongoing discussion.
    • Radiotherapy and chemotherapy are often deferred until tumour progression in patients with CNS WHO grade 2 tumours.
    • Patients with symptomatic and progressive tumours, with CNS WHO grade 3 tumours, or with large residual tumours after surgery usually receive immediate further treatment with radiotherapy and/or chemotherapy.
    • Adjuvant radiotherapy prolonged PFS but not OS in patients with progressive CNS WHO grade 2 gliomas.
    • Long-term follow-up data from randomized trials showed a major increase in OS after radiotherapy plus PCV chemotherapy in patients with CNS WHO grade 3 oligodendrogliomas.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Oligodendroglioma.docx

    Description

    This quiz covers the essential and desirable diagnostic criteria for gliomas, as well as prognosis and prediction based on survival data and molecular stratification.

    More Like This

    Brain Tumors and Gliomas
    5 questions

    Brain Tumors and Gliomas

    SensibleWhite avatar
    SensibleWhite
    Brain Tumors: Types and Symptoms
    7 questions

    Brain Tumors: Types and Symptoms

    RetractableSerendipity avatar
    RetractableSerendipity
    Gliomas and Brain Tumors
    40 questions

    Gliomas and Brain Tumors

    VeritableGeranium avatar
    VeritableGeranium
    Diagnostic Criteria for Adult Diffuse Gliomas
    10 questions

    Diagnostic Criteria for Adult Diffuse Gliomas

    CleanestVampire avatar
    CleanestVampire
    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser