TY  - JOUR
AU  - Park, Yae Won
AU  - Choi, Kyu Sung
AU  - Foltyn-Dumitru, Martha
AU  - Brugnara, Gianluca
AU  - Banan, Rouzbeh
AU  - Kim, Sooyon
AU  - Han, Kyunghwa
AU  - Park, Ji Eun
AU  - Kessler, Tobias
AU  - Bendszus, Martin
AU  - Krieg, Sandro
AU  - Wick, Wolfgang
AU  - Sahm, Felix
AU  - Choi, Seung Hong
AU  - Kim, Ho Sung
AU  - Chang, Jong Hee
AU  - Kim, Se Hoon
AU  - Wongsawaeng, Doonyaporn
AU  - Pollock, Jeffrey Michael
AU  - Lee, Seung-Koo
AU  - Barajas, Ramon Francisco
AU  - Vollmuth, Philipp
AU  - Ahn, Sung Soo
TI  - Incorporating Supramaximal Resection into Survival Stratification of IDH-Wildtype Glioblastoma: A Refined Multi-institutional Recursive Partitioning Analysis.
JO  - Clinical cancer research
VL  - 30
IS  - 21
SN  - 1078-0432
CY  - Philadelphia, Pa. [u.a.]
PB  - AACR
M1  - DKFZ-2024-01197
SP  - 4866-4875
PY  - 2024
N1  - 2024 Nov 1;30(21):4866-4875
AB  - To propose a novel recursive partitioning analysis (RPA) classification model in patients with IDH-wildtype glioblastomas that incorporates the recently expanded conception of the extent of resection (EOR) in terms of both supramaximal and total resections.This multicenter cohort study included a developmental cohort of 622 patients with IDH-wildtype glioblastomas from a single institution (Severance Hospital) and validation cohorts of 536 patients from three institutions (Seoul National University Hospital, Asan Medical Center, and Heidelberg University Hospital). All patients completed standard treatment including concurrent chemoradiotherapy and underwent testing to determine their IDH mutation and MGMTp methylation status. EORs were categorized into either supramaximal, total, or non-total resections. A novel RPA model was then developed and compared to a previous RTOG RPA model.In the developmental cohort, the RPA model included age, MGMTp methylation status, KPS, and EOR. Younger patients with MGMTp methylation and supramaximal resections showed a more favorable prognosis (class I: median overall survival [OS] 57.3 months), while low-performing patients with non-total resections and without MGMTp methylation showed the worst prognosis (class IV: median OS 14.3 months). The prognostic significance of the RPA was subsequently confirmed in the validation cohorts, which revealed a greater separation between prognostic classes for all cohorts compared to the previous RTOG RPA model.The proposed RPA model highlights the impact of supramaximal versus total resections and incorporates clinical and molecular factors into survival stratification. The RPA model may improve the accuracy of assessing prognostic groups.
LB  - PUB:(DE-HGF)16
C6  - pmid:38829906
DO  - DOI:10.1158/1078-0432.CCR-23-3845
UR  - https://inrepo02.dkfz.de/record/290600
ER  -