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Impact of H3.3 K27M Mutation on Prognosis and Survival of Grade IV Spinal Cord Glioma on the Basis of New 2016 World Health Organization Classification of the Central Nervous System

Authors
 Seong Yi  ;  Sunkyu Choi  ;  Dong Ah Shin  ;  Du Su Kim  ;  Junjeong Choi  ;  Yoon Ha  ;  Keung Nyun Kim  ;  Chang-Ok Suh  ;  Jong Hee Chang  ;  Se Hoon Kim  ;  Do Heum Yoon 
Citation
 Neurosurgery, : eprint, 2018 
Journal Title
 Neurosurgery 
ISSN
 0148-396X 
Issue Date
2018
Abstract
BACKGROUND: Spinal cord glioma grade IV is a rare, diffuse midline glioma. H3 K27M-mutant was classified in a different entity in the 2016 World Health Organization (WHO) classification recently. No reports about prognosis of spinal cord glioma grade IV are available yet. OBJECTIVE: To analyze the prognostic factors for spinal cord glioma grade IV. METHODS: Twenty-five patients with spinal cord glioma of grade IV who underwent surgery in a single institute were selected. All grade IV spinal cord glioma histologically confirmed as glioblastoma or "diffuse midline glioma with H3 K27M-mutant" by the 2016 WHO classification of the central nervous system were included. Basic demographics, treatment modalities, and pathological tumor molecular profiles were investigated for prognosis. RESULTS: Mean age was 39.1 yr; male to female ratio was 18 : 7. Tumor was located in thoracic cord (53.3%), cervical cord (40%), and lumbar area (6.7%). Median overall survival was 37.1 mo; median disease-free survival was 18.5 mo. Treatment modality showed no statistical difference. Only K27M profile showed significant prognostic value, 20 patients (80%) showed K27M mutation positive, K27M mutation patients showed longer overall survival (40.07 mo) than K27M negative patients (11.63 mo, P < .0001), and disease-free survival (20.85 vs 8.72 mo, P = .0241). CONCLUSION: This study is the first and largest report of the prognosis of primary spinal cord grade IV glioma using the new WHO classification. This study reported survival analysis and prognostic factors, and revealed that H3.3 K27M mutation is not a major poor prognostic factor. Further studies to explore K27M mutations needed for risk stratification and therapy optimization.
Full Text
https://academic.oup.com/neurosurgery/advance-article/doi/10.1093/neuros/nyy150/4990677
DOI
10.1093/neuros/nyy150
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
김긍년(Kim, Keung Nyun)
김세훈(Kim, Se Hoon) ORCID logo https://orcid.org/0000-0001-7516-7372
서창옥(Suh, Chang Ok)
신동아(Shin, Dong Ah) ORCID logo https://orcid.org/0000-0002-5225-4083
윤도흠(Yoon, Do Heum) ORCID logo https://orcid.org/0000-0003-1452-5724
이성(Yi, Seong)
장종희(Chang, Jong Hee)
하윤(Ha, Yoon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166753
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