Imaging growth and isocitrate dehydrogenase 1 mutation are independent predictors for diffuse low-grade gliomas.
BACKGROUND
We explored whether spontaneous imaging tumor growth (estimated by the velocity of diametric expansion) and isocitrate dehydrogenase 1 (IDH1) mutation (estimated by IDH1 immunoexpression) were independent predictors of long-term outcomes of diffuse low-grade gliomas in adults.


METHODS
One hundred thirty-one adult patients with newly diagnosed supratentorial diffuse low-grade gliomas were retrospectively studied.


RESULTS
Isocitrate dehydrogenase 1 mutations were present in 107 patients. The mean spontaneous velocity of diametric expansion was 5.40 ± 5.46 mm/y. During follow-up (mean, 70 ± 54.7 mo), 56 patients presented a malignant transformation and 23 died. The median malignant progression-free survival and the overall survival were significantly longer in cases of slow velocity of diametric expansion (149 and 198 mo, respectively) than in cases of fast velocity of diametric expansion (46 and 82 mo; P < .001 and P < .001, respectively) and in cases with IDH1 mutation (100 and 198 mo, respectively) than in cases without IDH1 mutation (72 mo and not reached; P = .028 and P = .001, respectively). In multivariate analyses, spontaneous velocity of diametric expansion and IDH1 mutation were independent prognostic factors for malignant progression-free survival (P < .001; hazard ratio, 4.23; 95% CI, 1.81-9.40 and P = .019; hazard ratio, 2.39; 95% CI, 1.19-4.66, respectively) and for overall survival (P < .001; hazard ratio, 26.3; 95% CI, 5.42-185.2 and P = .007; hazard ratio, 17.89; 95% CI, 2.15-200.1, respectively).


CONCLUSIONS
The spontaneous velocity of diametric expansion and IDH1 mutation status are 2 independent prognostic values that should be obtained at the beginning of the management of diffuse low-grade gliomas in adults.
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Catherine
C
Gozé
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Marie
M
Blonski
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Guillaume
G
Le Maistre
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Luc
L
Bauchet
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Edouard
E
Dezamis
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Philippe
P
Page
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Pascale
P
Varlet
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Laurent
L
Capelle
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Bertrand
B
Devaux
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Luc
L
Taillandier
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Hugues
H
Duffau
Cell Biology Laboratory, CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); INSERM U1051 Institut des Neurosciences de Montpellier, Montpellier, France (C.G., H.D., L.B.); Centre des Collections Biologiques Hospitalières de Montpellier (CCBH-M), CHU Gui de Chauliac Hospital, Montpellier, France (C.G.); Réseau d'Etude des Gliomes, REG, Groland, France (C.G., M.B., L.B., L.C., L.T., J.P.); Department of Neuro-Oncology, Nancy Neurological Hospital, Nancy, France (M.B., H.D., J.D.); Department of Neurosurgery, Sainte-Anne Hospital, Paris, France (G.L.M., E.D., P.P., B.D., J.P.); University Paris Descartes, Paris, France (G.L.M., E.D., P.P., P.V., B.D., J.P.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier, France (L.B., H.D.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Paris, France (L.C.); Department of Neuro-Oncology, CHU de Poitiers, Université de Poitiers, Poitiers, France (L.T.).
Johan
J
Pallud
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000235:genetics* / Q000473:pathology*; D005260:Female; D005820:Genetic Testing; D005910:Glioma / Q000235:genetics* / Q000473:pathology*; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D060787:Neoplasm Grading; D011379:Prognosis; D012189:Retrospective Studies
D007521:Isocitrate Dehydrogenase; C543588:IDH1 protein, human
isocitrate dehydrogenase 1; low-grade glioma; prognosis; velocity of tumor expansion