Incorporating Supramaximal Resection into Survival Stratification of IDH-wildtype Glioblastoma: A Refined Multi-institutional Recursive Partitioning Analysis
1
Issued Date
2024-11-01
Resource Type
ISSN
10780432
eISSN
15573265
Scopus ID
2-s2.0-85204153364
Pubmed ID
38829906
Journal Title
Clinical Cancer Research
Volume
30
Issue
21
Start Page
4866
End Page
4875
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Cancer Research Vol.30 No.21 (2024) , 4866-4875
Suggested Citation
Park Y.W., Choi K.S., Foltyn-Dumitru M., Brugnara G., Banan R., Kim S., Han K., Park J.E., Kessler T., Bendszus M., Krieg S., Wick W., Sahm F., Choi S.H., Kim H.S., Chang J.H., Kim S.H., Wongsawaeng D., Pollock J.M., Lee S.K., Barajas R.F., Vollmuth P., Ahn S.S. Incorporating Supramaximal Resection into Survival Stratification of IDH-wildtype Glioblastoma: A Refined Multi-institutional Recursive Partitioning Analysis. Clinical Cancer Research Vol.30 No.21 (2024) , 4866-4875. 4875. doi:10.1158/1078-0432.CCR-23-3845 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/102000
Title
Incorporating Supramaximal Resection into Survival Stratification of IDH-wildtype Glioblastoma: A Refined Multi-institutional Recursive Partitioning Analysis
Author's Affiliation
Medizinischen Fakultät der Universität Bonn
Siriraj Hospital
OHSU School of Medicine
Universitätsklinikum Bonn
Seoul National University Hospital
German Cancer Research Center
Yonsei University
Oregon Health & Science University
Yonsei University College of Medicine
University of Ulsan College of Medicine
Universitätsklinikum Heidelberg
Siriraj Hospital
OHSU School of Medicine
Universitätsklinikum Bonn
Seoul National University Hospital
German Cancer Research Center
Yonsei University
Oregon Health & Science University
Yonsei University College of Medicine
University of Ulsan College of Medicine
Universitätsklinikum Heidelberg
Corresponding Author(s)
Other Contributor(s)
Abstract
Purpose: 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. Experimental Design: 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 with a previous Radiation Therapy Oncology Group (RTOG) RPA model. Results: In the developmental cohort, the RPA model included age, MGMTp methylation status, Karnofsky performance status, and EOR. Younger patients with MGMTp methylation and supramaximal resections showed a more favorable prognosis [class I: median overall survival (OS) 57.3 months], whereas 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 with the previous RTOG RPA model. Conclusions: 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.