Pediatric high-grade gliomas and the WHO CNS Tumor Classification-Perspectives of pediatric neuro-oncologists and neuropathologists in light of recent updates
Por:
Gielen GH, Baugh JN, van Vuurden DG, Veldhuijzen van Zanten SEM, Hargrave D, Massimino M, Biassoni V, Morales-La Madrid A, Karremann M, Wiese M, Thomale U, Janssens GO, von Bueren AO, Perwein T, Nussbaumer G, Hoving EW, Niehusmann P, Gessi M, Kwiecien R, Bailey S, Pietsch T, Andreiuolo F and Kramm CM
Publicada:
1 jun 2022
Ahead of Print:
1 jun 2022
Resumen:
Background The WHO Classification of Tumors of the Central Nervous System has undergone major restructuring. Molecularly defined diagnostic criteria were introduced in 2016 (revised 4th edition) and expanded in 2021 (5th edition) to incorporate further essential diagnostic molecular parameters. We investigated potential differences between specialists in perception of these molecularly defined subtypes for pediatric high-grade gliomas (pedHGG).
Methods We designed a 22-question survey studying the impact of the revised 4th edition of the WHO classification on pedHGG. Data were collected and statistically analyzed to examine the spectrum of viewpoints and possible differences between neuro-oncologists and neuropathologists.
Results 465 participants from 53 countries were included; 187 pediatric neuro-oncologists (40%), 160 neuropathologists (34%), and 118 additional experts (26%). Neuro-oncologists reported issues with the introduction of molecularly defined tumor types, as well as the abolishment or renaming of established tumor entities, while neuropathologists did not to the same extent. Both groups indicated less relevant or insufficient diagnostic definitions were available in 2016. Reported issues were classified and assessed in the 2021 WHO classification and a substantial improvement was perceived. However, issues of high clinical relevance remain to be addressed, including the definition of clinical phenotypes for diffuse intrinsic pontine glioma and gliomatosis cerebri.
Conclusions Within the WHO classification of pediatric brain tumors, such as pedHGG, rapid changes in molecular characterization have been introduced. This study highlights the ongoing need for cross talk between pathologist and oncologist to advance the classification of pedHGG subtypes and ensure biological relevance and clinical impact.
Filiaciones:
Gielen GH:
Institute of Neuropathology, Medical Center Bonn, Bonn, Germany
Baugh JN:
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
van Vuurden DG:
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Veldhuijzen van Zanten SEM:
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Hargrave D:
Great Ormond Street Hospital for Children, NHS Trust, London, UK
Massimino M:
Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan, Italy
Biassoni V:
Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan, Italy
Morales-La Madrid A:
Pediatric Neuro-Oncology, Department of Pediatric Oncology, Hospital Sant Joan de Deu, Passeig Sant Joan de Déu 2, Barcelona, Spain
Karremann M:
Department of Pediatric and Adolescent Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Wiese M:
Division of Pediatric Hematology and Oncology , University Medical Center Goettingen, Goettingen, Germany
Thomale U:
Pediatric Neurosurgery, Charité Universitätsmedizin Berlin, Berlin, Germany
Janssens GO:
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
von Bueren AO:
Division of Pediatric Oncology and Hematology, Department of Women, Child and Adolescent, University Hospital of Geneva, Geneva, Switzerland
Perwein T:
Division of Pediatric Hemato-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
Nussbaumer G:
Division of Pediatric Hemato-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
Hoving EW:
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Niehusmann P:
Department of Neuropathology, Oslo University Hospital, Oslo, Norway
Gessi M:
Department of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Kwiecien R:
Institute of Biostatistics and Clinical Research, Faculty of Medicine, University of Münster, Münster, Germany
Bailey S:
Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne, UK
Pietsch T:
Institute of Neuropathology, Medical Center Bonn, Bonn, Germany
Andreiuolo F:
Institute of Neuropathology, Medical Center Bonn, Bonn, Germany
Kramm CM:
Division of Pediatric Hematology and Oncology , University Medical Center Goettingen, Goettingen, Germany
Green Submitted, Green Published, gold
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