Evidence map›Paper›PMID 41539974›Full record

ArticleAnnals of clinical and translational neurology2026

Association of CDKN2A/B Homozygous Deletion and Extent of Resection With Survival of Patients With WHO CNS5 Grade 4 Astrocytoma.

Jiawei Cai, Guanglin Zhu, Qiu He, Chen Luo, Lingyun Zhuo, Xingfu Wang, Yiming Chen, Xiaoyong Chen, Wendong You, Jiaheng Xu and 4 more

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Article in Annals of clinical and translational neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Jiawei CaiDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Guanglin ZhuDepartment of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Qiu HeDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Chen LuoDepartment of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Lingyun ZhuoDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Xingfu WangDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Yiming ChenSchool of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China.
Xiaoyong ChenDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Wendong YouDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Jiaheng XuDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Yuanxiang LinDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Dezhi KangDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.ORCID 0009-0001-5941-9741
Shuai WuDepartment of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Zanyi WuDepartment of Neurosurgery, Neurosurgery Research Institute, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.ORCID 0000-0001-8627-9134

Funding

Joint Funds for the Innovation of Science and Technology, Fujian Province 2025Y9194Natural Science Foundation of Fujian Province 2023J01602Neurosurgery Department High-Level Innovation Construction Project for Major Research at the Neurological Diseases Center 2023YSJYX-ZD-2
6 · The paper itself

Abstract

objectivesWHO grade 4 astrocytomas are associated with poor prognosis, and their prognostic factors remain controversial. This study aimed to identify the prognostic factors and develop a management algorithm for these patients.

methodsThis study retrospectively included 151 CNS5 adult grade 4 astrocytomas from two medical centers. The tumors were classified as histologic grade 2/3 astrocytomas with CDKN2A/B homozygous deletion (molecular grade 4 astrocytoma, MA4), histologic grade 4 astrocytomas with CDKN2A/B homozygous deletion (molecular and histologic grade 4 astrocytoma, MHA4), and histologic grade 4 astrocytomas without CDKN2A/B homozygous deletion (histologic grade 4 astrocytoma, HA4). Prognostic factors were identified and incorporated into recursive partitioning analysis (RPA) for survival risk stratification.

resultsHistologic grade 4 astrocytomas with CDKN2A/B homozygous deletion, postoperative tumor volume (TV), and chemoradiotherapy were associated with patient survival. RPA identified three groups with distinct prognoses (p = 0.001). Group 1 had a median overall survival (OS) of 77.8 months, consisting of MA4 and HA4 with postoperative TV on FLAIR ≤ 28.5 mL. Group 2 had a median OS of 32.2 months, including MA4 and HA4 with postoperative TV on FLAIR > 28.5 mL receiving chemoradiotherapy, or MHA4 with postoperative TV on FLAIR ≤ 28.5 mL. Group 3 had a median OS of 14.9 months, including MA4 and HA4 with postoperative TV on FLAIR > 28.5 mL without chemoradiotherapy, or MHA4 with postoperative TV on FLAIR > 28.5 mL receiving chemoradiotherapy.

conclusionHistologic grade 4 astrocytomas with CDKN2A/B homozygous deletion confer the worst survival. Maximal or complete resection, as assessed on FLAIR images, is critical to improving outcomes.

Indexed as

AstrocytomaBrain NeoplasmsCyclin-Dependent Kinase Inhibitor p15Cyclin-Dependent Kinase Inhibitor p16AdultAgedFemaleGene DeletionHomozygoteHumansMaleMiddle AgedNeoplasm GradingPrognosisRetrospective StudiesYoung AdultCDKN2A protein, humanCDKN2B protein, humanCyclin-Dependent Kinase Inhibitor p15Cyclin-Dependent Kinase Inhibitor p16CDKN2A/Bextent of resectiongrade 4 astrocytomamanagement algorithmprognosis

Identifiers

PMID41539974
PMCPMC13251431

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.