ArticleActa neuropathologica2015
IDH mutation status and role of WHO grade and mitotic index in overall survival in grade II-III diffuse gliomas.
Article in Acta neuropathologica, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 207 papers, 6 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
207 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Molecular Biomarker Testing for the Diagnosis of Diffuse Gliomas.Archives of pathology & laboratory medicine · 2022Guideline
- The role of neuropathology in the management of newly diagnosed glioblastoma: a systematic review and evidence-based clinical practice guideline.Journal of neuro-oncology · 2020Pooled it
- Isocitrate Dehydrogenase, Patient-Reported Outcomes, and Cognitive Functioning of Glioma Patients: a Systematic Review.Current oncology reports · 2020Pooled it
- The prognostic significance of CDKN2A homozygous deletion in IDH-mutant lower-grade glioma and glioblastoma: a systematic review of the contemporary literature.Journal of neuro-oncology · 2020Pooled it
- IDH wild-type WHO grade II diffuse low-grade gliomas. A heterogeneous family with different outcomes. Systematic review and meta-analysis.Neurosurgical review · 2020Pooled it
- SEOM clinical guideline of diagnosis and management of low-grade glioma (2017).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2018Guideline
- [Development and Evaluation of Prognostic Nomogram Model for Adult Ventricle Glioma Patients].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2022Trial
- Ultra-high-field sodium MRI as biomarker for tumor extent, grade and IDH mutation status in glioma patients.NeuroImage. Clinical · 2020Trial
- Reducing radiation dose to normal brain through a risk adapted dose reduction protocol for patients with favourable subtype anaplastic glioma.Radiation oncology (London, England) · 2017Trial
- Feasibility of High-Intensity Interval Exercise in Young Adult Survivors of Pediatric Brain Tumor and Young Adults With Isocitrate Dehydrogenase-Mutant Gliomas (HYPE): Protocol for a Randomized Controlled Trial.JMIR research protocols · 2026Article
- Clinicopathological Implications of IDH1 Mutation and Ki-67 Expression Across WHO Grades of Gliomas: Insights from a Prospective Observational Study.Iranian journal of pathology · 2026Article
- Expanding the molecular grading criteria in IDH-mutant astrocytoma.Neuro-oncology · 2026Article
- Article
- Amsterdam IMAging and Clinical GliOma Dataset; IMAGO.Scientific data · 2026Article
- CATNON conclusion: Closure on concurrent chemotherapy in IDH mutant grade 3 astrocytoma.Neuro-oncology · 2026Article
- IDH Mutation Assessment in Gliomas from Anatomical MRI Using Deep Learning: A Comparative Analysis of Centralized and Federated Learning Frameworks.Diagnostics (Basel, Switzerland) · 2026Article
- Review
- Revisiting prognosis of oligodendroglioma patients in the 2021 WHO classification: incremental value of imaging features.European radiology · 2026Article
- Clinicopathologic and FISH-Based Evaluation of CDKN2A/B and EGFR in IDH Mutant Astrocytomas.Noro psikiyatri arsivi · 2026Article
- MRI-based prediction of DNA methylation grade in IDH-mutant astrocytomas using qualitative imaging features and tumor volumetrics.Neuroradiology · 2025Article
147 more citing papers are in PubMed but not listed here.
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Authors and funding
15 authors.
Funding
Abstract
Diffuse gliomas are up till now graded based upon morphology. Recent findings indicate that isocitrate dehydrogenase (IDH) mutation status defines biologically distinct groups of tumors. The role of tumor grade and mitotic index in patient outcome has not been evaluated following stratification by IDH mutation status. To address this, we interrogated 558 WHO grade II-III diffuse gliomas for IDH1/2 mutations and investigated the prognostic impact of WHO grade within IDH-mutant and IDH-wild type tumor subsets independently. The prognostic impact of grade was modest in IDH-mutant [hazard ratio (HR) = 1.21, 95 % confidence interval (CI) = 0.91-1.61] compared to IDH-wild type tumors (HR = 1.74, 95 % CI = 0.95-3.16). Using a dichotomized mitotic index cut-off of 4/1000 tumor cells, we found that while mitotic index was significantly associated with outcome in IDH-wild type tumors (log-rank p < 0.0001, HR = 4.41, 95 % CI = 2.55-7.63), it was not associated with outcome in IDH-mutant tumors (log-rank p = 0.5157, HR = 1.10, 95 % CI = 0.80-1.51), and could demonstrate a statistical interaction (p < 0.0001) between IDH mutation and mitotic index (i.e., suggesting that the effect of mitotic index on patient outcome is dependent on IDH mutation status). Patient age, an established prognostic factor in diffuse glioma, was significantly associated with outcome only in the IDH-wild type subset, and consistent with prior data, 1p/19q co-deletion conferred improved outcome in the IDH-mutant cohort. These findings suggest that stratification of grade II-III gliomas into subsets defined by the presence or absence of IDH mutation leads to subgroups with distinct prognostic characteristics. Further evaluation of grading criteria and prognostic markers is warranted within IDH-mutant versus IDH-wild type diffuse grade II-III gliomas as independent entities.
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