Evidence-based diagnostic algorithm for glioma: Analysis of the results of pathology panel review and molecular parameters of EORTC 26951 and 26882 trials

Johan M. Kros, Karin Huizer, Aurelio Hernández-Laín, Gianluca Marucci, Alex Michotte, Bianca Pollo, Elisabeth J. Rushing, Teresa Ribalta, Pim French, David Jaminé, Nawal Bekka, Denis Lacombe, Martin J. Van Den Bent, Thierry Gorlia

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: With the rapid discovery of prognostic and predictive molecular parameters for glioma, the status of histopathology in the diagnostic process should be scrutinized. Our project aimed to construct a diagnostic algorithm for gliomas based on molecular and histologic parameters with independent prognostic values. Methods: The pathology slides of 636 patients with gliomas who had been included in EORTC 26951 and 26882 trials were reviewed using virtual microscopy by a panel of six neuropathologists who independently scored 18 histologic features and provided an overall diagnosis. The molecular data for IDH1, 1p/19q loss, EGFR amplification, loss of chromosome 10 and chromosome arm 10q, gain of chromosome 7, and hypermethylation of the promoter of MGMT were available for some of the cases. The slides were divided in discovery (n = 426) and validation sets (n = 210). The diagnostic algorithm resulting from analysis of the discovery set was validated in the latter. Results: In 66% of cases, consensus of overall diagnosis was present. A diagnostic algorithm consisting of two molecular markers and one consensus histologic feature was created by conditional inference tree analysis. The order of prognostic significance was: 1p/19q loss, EGFR amplification, and astrocytic morphology, which resulted in the identification of four diagnostic nodes. Validation of the nodes in the validation set confirmed the prognostic value (P <.001). Conclusion: We succeeded in the creation of a timely diagnostic algorithm for anaplastic glioma based on multivariable analysis of consensus histopathology and molecular parameters.

Original languageEnglish
Pages (from-to)1943-1950
Number of pages8
JournalJournal of Clinical Oncology
Volume33
Issue number17
DOIs
Publication statusPublished - Jun 10 2015

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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