ArticleNeuro-oncology2024
Insights from a multicenter study on adult H3 K27M-mutated glioma: Surgical resection's limited influence on overall survival, ATRX as molecular prognosticator.
Article in Neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Limitations of nomogram models in predicting survival outcomes for glioma patients.Frontiers in immunology · 2025Pooled it
- Laser insterstitial thermal therapy followed by craniotomy for tumor resection for pediatric diffuse midline glioma: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Epigenetic mechanisms and therapeutic advances in diffuse midline glioma (Review).Oncology reports · 2026Review
- Adult-Onset Diffuse Midline Glioma, H3K27-Altered: A Genomics-Guided, Individualized, Multimodal Treatment Approach.Brain sciences · 2026Article
- Early distant progression in adult Histone-3 K27-altered diffuse midline gliomas.Journal of neuro-oncology · 2026Article
- Histologically indolent but widely disseminated diffuse midline glioma H3K27-altered revealed by autopsy.Brain tumor pathology · 2026Article
- The great imitator: clinical, surgical, and molecular insights into diffuse midline gliomas, H3 K27-altered. Illustrative cases.Journal of neurosurgery. Case lessons · 2025Article
- AI-augmented intraoperative decision-making workflows in diffuse midline glioma biopsy using cryosection pathology.Nature communications · 2025Article
- Diffuse pontine glioma (DPG): shorter or longer treatment time?Journal of neuro-oncology · 2025Article
- Leptomeningeal dissemination in H3 K27M- mutant diffuse midline gliomas: clinical characteristics, risk factors, and prognostic insights.Journal of neuro-oncology · 2025Article
- Diffuse midline (H3 K27M-mutant) glioma in adults-When resection fails to matter.Neuro-oncology · 2024Article
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24 authors.
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Abstract
backgroundH3 K27M-mutated gliomas were first described as a new grade 4 entity in the 2016 World Health Organization classification. Current studies have focused on its typical appearance in children and young adults, increasing the need to better understand the prognostic factors and impact of surgery on adults. Here, we report a multicentric study of this entity in adults.
methodsWe included molecularly confirmed H3 K27M-mutated glioma cases in patients ≥ 18 years diagnosed between 2016 and 2022. Clinical, radiological, and surgical features were analyzed. Univariate and multivariate analyses were performed to identify prognostic factors.
resultsAmong 70 patients with a mean age of 36.1 years, the median overall survival (OS) was 13.6 ± 14 months. Gross-total resection was achieved in 14.3% of patients, whereas 30% had a subtotal resection and 54.3% a biopsy. Tumors located in telencephalon/diencephalon/myelencephalon were associated with a poorer OS, while a location in the mesencephalon/metencephalon showed a significantly longer OS (8.7 vs. 25.0 months, P = .007). Preoperative Karnofsky-Performance Score (KPS) ≤ 80 showed a reduced OS (4.2 vs. 18 months, P = .02). Furthermore, ATRX loss, found in 25.7%, was independently associated with an increased OS (31 vs. 8.3 months, P = .0029). Notably, patients undergoing resection showed no survival benefit over biopsy (12 vs. 11 months, P = .4006).
conclusionsThe present study describes surgical features of H3 K27M-mutated glioma in adulthood in a large multicentric study. Our data reveal that ATRX status, location and KPS significantly impact OS in H3 K27M-mutated glioma. Importantly, our dataset indicates that resection does not offer a survival advantage over biopsy.
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