Prognostic Impact of the Combination of MGMT Methylation and TERT Promoter Mutation in Glioblastoma

Abstract

Background The concept of combinational analysis between the methylation of O6-methylguanine-DNA methyltransferase (MGMT) and telomerase reverse transcriptase promoter (pTERT) mutation in glioblastoma (GBM) has been reported. The main study objective was to determine the prognosis of patients with GBM based on MGMT/pTERT classification, while the secondary objective was to estimate the temozolomide effect on the survival time of GBM with MGMT/pTERT classification. Methods A total of 50 GBM specimens were collected after tumor resection and were selected for investigating MGMT methylation and pTERT mutation. Clinical imaging and pathological characteristics were retrospectively analyzed. Patients with MGMT/pTERT classification were analyzed using survival analysis to develop the nomogram for forecasting and individual prognosis. Results All patients underwent resection (total resection: 28%, partial resection: 64%, biopsy: 8%). Thirty-two percent of all cases received adjuvant temozolomide with radiotherapy. Sixty-four percent of the case was found methylated MGMT, and 56% of the present cohort found pTERT mutation. Following combinational analysis of biomarkers, results showed that the GBMs with methylated MGMT and wild-type pTERT had a superior prognosis compared with other subtypes. Using Cox regression analysis with multivariable analysis, the extent of resection, postoperative chemoradiotherapy, MGMT/pTERT classification were associated with a favorable prognosis. Hence, a web-based nomogram was developed for deploying individual prognostication. Conclusions The interaction of MGMT methylation and pTERT mutation was confirmed for predicting prognosis. The results from the present study could help physicians create treatment strategies for GBM patients in real-world situations.

Factors Associated with Recurrence in Chronic Subdural Hematoma following Surgery

“…When there are several time endpoints, a time-to-event analysis may better capture the natural course of CSDH and be more appropriate than binary logistic regression. 14,15 Risk factors related to the recurrence of CSDH following surgery have still been discussed and are uncertain from prior studies. As result, preoperative clopidogrel usage and the amount of saline irrigation were potentially associated with the recurrence of CSDH in this study.…”

“…When there are several time endpoints, a time-to-event analysis may better capture the natural course of CSDH and be more appropriate than binary logistic regression. 14 15…”

“…Time-toevent analysis has been used to investigate factors that may have an impact on the outcomes during follow-up, especially neuro-oncology. 14,15 Therefore, the purpose of this study was to describe the recurrent rate of CSDH after surgery. Additionally, a secondary objective was to evaluate factors associated with the recurrence of CSDH after surgery by time-to-event analysis.…”

“…Time-to-event analysis has been used to investigate factors that may have an impact on the outcomes during follow-up, especially neuro-oncology. 14 15…”

MGMT unmethylation and high levels of CD47 and TIGIT indicate a poor prognosis in adult diffuse gliomas

“…Meanwhile, patients with IDH wild-type and TERT promoter (pTERT) mutant gliomas in the new classification are also diagnosed with GBM. Studies on the status of pTERT and MGMT in GBM have also been reported (5), but there are few studies on pTERT mutations and MGMT methylation status in other types of ADG in the new classification.…”