Clinical Characteristics and Prognostic Factors in H3 K27- altered Diffuse Midline Gliomas: A 64 Cases Retrospective Cohort Analysis

Abstract

Purpose This study aims to systematically assess patient characteristics, identify clinical factors guiding treatment decisions, and predict the prognosis of H3 K27-altered Diffuse Midline Glioma (DMG/K27M). Methods A retrospective review of 64 consecutive DMG/K27M patients was conducted. Patient clinical profiles, treatment approaches, and follow-up data were collected from a Chinese tertiary institution between August 2016 and August 2022. Analysis of overall survival (OS) was conducted using Kaplan–Meier modeling and univariate and multivariate Cox regression analyses to identify prognostic factors. Results Among the 64 patients included in the study, the median OS was 9 months. Thalamus was the tumor location for 53.1% (34/64), with 39.1% (25/64) presenting dizziness as their initial symptom. Patients with dizziness were younger (23.04 vs. 30.7 years, p = 0.0328), exhibited larger tumor volume (27.380 vs. 11.680 cm3, p = 0.0359), and displayed extended overall survival (13.00 vs. 8.00 months, p = 0.0017) compared to those without dizziness. In addition, univariate and multivariate analysis showed that tumor location, dizziness, Karnofsky performance status (KPS) score and treatment regimen were prognostic factors for OS (p < 0.05), whereas age was not significantly correlated with OS. Conclusion Patients without dizziness as the initial symptom may face a challenging prognosis compared to the dizziness (+) group. Tumor location, dizziness, KPS, and treatment regimen could serve as independent prognostic indicators. These findings contribute novel insights for evidence-based practices in DMG/K27M research.