Oncology · 2 h ago
Enhancement Not Linked to Worse Outcomes in Grade 2 IDH-Mutant Glioma
A retrospective two-institution study of 325 patients found no significant association between preoperative contrast enhancement and overall or progression-free survival. The findings suggest enhancement alone may not identify a higher-risk subgroup or rule out consideration of vorasidenib, but do not establish treatment benefit.
- Enhancement was present in 16% of patients.
- No significant association with overall or progression-free survival.
- Enhancement alone may not rule out vorasidenib consideration.
Researchers retrospectively assessed 325 consecutive patients with newly diagnosed grade 2 IDH-mutant glioma treated at two institutions from 2010 to 2021. Two independent readers evaluated preoperative MRI scans for intratumoral contrast enhancement, with a third reader adjudicating disagreements. Median follow-up was 10.5 years; median patient age was 37, and 47% had 1p/19q codeletion.
Enhancement was present in 53 patients (16%). It was most commonly nonmeasurable (72%) or ill-defined (62%); 87% of patients with preoperative enhancement had no residual postoperative enhancement. Enhancement was not significantly associated with overall survival (unadjusted HR 1.16, 95% CI 0.67–2.01) or progression-free survival (HR 1.25, 95% CI 0.88–1.80). Results remained nonsignificant after adjustment for established prognostic factors. Measurable size and well-defined morphology were also not associated with overall survival.
The findings indicate that preoperative enhancement alone did not identify a higher-risk subgroup in this cohort and, the authors suggest, should not by itself preclude consideration of vorasidenib in eligible patients. The retrospective design limits causal conclusions; the study does not assess vorasidenib’s treatment effect or establish eligibility criteria.
In practice
For patients with newly diagnosed grade 2 IDH-mutant glioma, this retrospective cohort found that preoperative contrast enhancement was not significantly associated with overall or progression-free survival, including after adjustment for established prognostic factors. The authors suggest enhancement alone should not preclude consideration of vorasidenib in eligible patients. This is prognostic evidence from two institutions, not a trial of vorasidenib; it does not establish treatment benefit or show that enhancement is irrelevant to other clinical decisions.
AI-generated clinical interpretation · Not editor-reviewed
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Neuro-Oncology: Prognostic Significance of Contrast Enhancement in Newly Diagnosed Grade 2 IDH-mutant Glioma ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.