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@ARTICLE{Blobner:303080,
      author       = {J. Blobner and V. Ruf and J. Weller and N. Teske and R.
                      Forbrig and N. Thon and N. L. Albert and L. von
                      Baumgarten$^*$ and S. Schoenecker and J.-C. Tonn and F.
                      Ringel and P. Harter$^*$ and P. Karschnia},
      title        = {{C}linical and neuropathological criteria for
                      distinguishing between {IDH}-mutant astrocytomas of {WHO}
                      grade 2 and 3.},
      journal      = {Journal of neuro-oncology},
      volume       = {175},
      number       = {2},
      issn         = {0167-594X},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V},
      reportid     = {DKFZ-2025-01505},
      pages        = {763-774},
      year         = {2025},
      note         = {2025 Nov;175(2):763-774},
      abstract     = {The 2021 WHO classification of CNS tumors allows
                      flexibility in the grading of IDH-mutant astrocytic gliomas,
                      leading to some ambiguity. Following the approval of
                      vorasidenib for WHO grade 2 astrocytomas and
                      oligodendrogliomas based on the positive Phase III INDIGO
                      trial, identifying prognostic criteria to differentiate
                      between grade 2 and grade 3 tumors has become increasingly
                      important.We retrospectively searched our institutional
                      database for patients meeting the diagnostic criteria for
                      IDH-mutant astrocytomas (grade 2 and 3) according to the WHO
                      2021 classification. Clinical, radiological and molecular
                      data were collected; outcome was compared using log-rank
                      analysis and prognostic markers were subsequently forwarded
                      in a multivariate model.We identified 91 patients with
                      IDH-mutant astrocytomas with available neuropathological and
                      clinical data, including 61 WHO grade 2 $(67.0\%)$ and 30
                      WHO grade 3 $(33.0\%)$ tumors. At a median follow-up of 89
                      months, median progression-free survival was 67 months for
                      WHO grade 2 and 53 months for WHO grade 3 tumors. Median
                      overall survival was 216 months for WHO grade 3 tumors,
                      while it was not reached for WHO grade 2 tumors. Univariate
                      analysis showed that higher WHO grade, increased mitotic
                      count, elevated Ki67 indices and preoperative contrast
                      enhancement were associated with poorer outcomes; however,
                      only contrast enhancement retained prognostic significance
                      on multivariate analysis (p = 0.03 for overall survival, p =
                      0.02 for progression-free survival).While our findings await
                      confirmation in larger prospective cohorts,
                      neuropathological grading criteria might need to be
                      accompanied by clinical information including contrast
                      enhancement to prognostically distinguish grade 2 from grade
                      3 tumors.},
      keywords     = {Astrocytoma (Other) / Contrast-enhancement (Other) /
                      Grading (Other) / IDH-inhibitor (Other) / IDH-mutant (Other)
                      / Mitotic count (Other)},
      cin          = {MU01},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40702387},
      doi          = {10.1007/s11060-025-05173-z},
      url          = {https://inrepo02.dkfz.de/record/303080},
}