Träger, Malte; Schweizer, Leonille; Eilís, Pérez; Schmid, Simone; Hain, Elisabeth G; Dittmayer, Carsten; Onken, Julia; Fukuoka, Kohei; Ichimura, Koichi; Schüller, Ulrich; Dührsen, Lasse; Müther, Michael; Paulus, Werner; Thomas, Christian; Gutt-Will, Marielena; Schucht, Philippe; Maragkou, Theoni; Schittenhelm, Jens; Eckert, Franziska; Niyazi, Maximilian; ... (2023). Adult intracranial ependymoma - relevance of DNA methylation profiling for diagnosis, prognosis and treatment. Neuro-Oncology, 25(7), pp. 1286-1298. Oxford University Press 10.1093/neuonc/noad030
Full text not available from this repository. (Request a copy)BACKGROUND
A methylation-based classification of ependymoma has recently found broad application. However, the diagnostic advantage and implications for treatment decisions remain unclear. Here, we retrospectively evaluate the impact of surgery and radiotherapy on outcome after molecular reclassification of adult intracranial ependymomas.
METHODS
Tumors diagnosed as intracranial ependymomas from 170 adult patients collected from eight diagnostic institutions were subjected to DNA methylation profiling. Molecular classes, patient characteristics, and treatment were correlated with progression-free survival (PFS).
RESULTS
The classifier indicated an ependymal tumor in 73.5%, a different tumor entity in 10.6% and non-classifiable tumors in 15.9% of cases, respectively. The most prevalent molecular classes were posterior fossa ependymoma group B (EPN-PFB, 32.9%), posterior fossa subependymoma (PF-SE, 25.9%), and supratentorial ZFTA fusion-positive ependymoma (EPN-ZFTA, 11.2%). With a median follow-up of 60.0 months, the 5- and 10-year-PFS rates were 64.5% and 41.8% for EPN-PFB, 67.4% and 45.2% for PF-SE and 60.3% and 60.3% for EPN-ZFTA. In EPN-PFB, but not in other molecular classes, gross total resection (p=0.009) and postoperative radiotherapy (p=0.007) were significantly associated with improved PFS in multivariable analysis. Histological tumor grading (WHO 2 vs. 3) was not a predictor of prognosis within molecularly defined ependymoma classes.
CONCLUSIONS
DNA methylation profiling improves diagnostic accuracy and risk stratification in adult intracranial ependymoma. The molecular class of PF-SE is unexpectedly prevalent among adult tumors with ependymoma histology and relapsed as frequently as EPN-PFB, despite the supposed benign nature. Gross total resection and radiotherapy may represent key factors in determining the outcome of EPN-PFB patients.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology 04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery |
UniBE Contributor: |
Gutt-Will, Marielena Margarethe, Schucht, Philippe, Maragkou, Theoni |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1523-5866 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
06 Feb 2023 14:36 |
Last Modified: |
08 Jul 2023 00:12 |
Publisher DOI: |
10.1093/neuonc/noad030 |
PubMed ID: |
36734226 |
Uncontrolled Keywords: |
DNA methylation adult ependymoma intracranial radiotherapy |
URI: |
https://boris.unibe.ch/id/eprint/178350 |
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