期刊
NEURO-ONCOLOGY
卷 24, 期 5, 页码 796-808出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/neuonc/noab213
关键词
meningioma; copy-number alterations
资金
- Brigham Research Institute Precision Medicine Award
- Brain Science Foundation
- National Institute of General Medical Sciences [T32GM007753]
- Biomedical Informatics and Data Science Research Training Program [T15LM007098]
- Jared Branfman Sunflowers for Life Fund
A molecularly integrated grading scheme for meningiomas was proposed, which significantly improved upon the current WHO grading system in predicting progression-free survival. This framework can be broadly adopted by clinicians using widely available genomic technologies and presents an advance in the care of meningioma patients.
Background Meningiomas are the most common primary intracranial tumor in adults. Clinical care is currently guided by the World Health Organization (WHO) grade assigned to meningiomas, a 3-tiered grading system based on histopathology features, as well as extent of surgical resection. Clinical behavior, however, often fails to conform to the WHO grade. Additional prognostic information is needed to optimize patient management. Methods We evaluated whether chromosomal copy-number data improved prediction of time-to-recurrence for patients with meningioma who were treated with surgery, relative to the WHO schema. The models were developed using Cox proportional hazards, random survival forest, and gradient boosting in a discovery cohort of 527 meningioma patients and validated in 2 independent cohorts of 172 meningioma patients characterized by orthogonal genomic platforms. Results We developed a 3-tiered grading scheme (Integrated Grades 1-3), which incorporated mitotic count and loss of chromosome 1p, 3p, 4, 6, 10, 14q, 18, 19, or CDKN2A. 32% of meningiomas reclassified to either a lower-risk or higher-risk Integrated Grade compared to their assigned WHO grade. The Integrated Grade more accurately identified meningioma patients at risk for recurrence, relative to the WHO grade, as determined by time-dependent area under the curve, average precision, and the Brier score. Conclusion We propose a molecularly integrated grading scheme for meningiomas that significantly improves upon the current WHO grading system in prediction of progression-free survival. This framework can be broadly adopted by clinicians with relative ease using widely available genomic technologies and presents an advance in the care of meningioma patients.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据