Overview of prognostic factors in adult glioma; a 10-year experience at a single institution

Objective The most prevalent central nervous system (CNS) neoplasm arising from glial cells is glioma, which diffusely invades brain tissue. Among gliomas, Glioblastoma (GBM) is a glioma of the highest grade and associated with a grim prognosis, with a median overall survival of 15 months with and 3-4 months without therapy. We examined how clinical variables and molecular profiles may have affected overall survival (OS) at Sina Hospital in Tehran over the past ten years. Methods A retrospective study was conducted at Sina Hospital in Tehran, Iran, and examined patients ≥ 11 years with confirmed glioma diagnoses between 2012 and 2020. We evaluated the correlation between OS in GBM patients and sociodemographic as well as clinical factors, including age, gender, extent of tumor resection, tumor location, chemo/radiotherapy, and molecular profiling based on IDH1, MGMT, TERT, and EGFR status. Kaplan-Meier and multivariate Cox regression models were used to assess patient survival. Results Following a comprehensive evaluation of medical records, 186 patients were enrolled in the study. The median OS was 20 months, with a 2-year survival rate of 62.5%. Among the 132 patients with available IDH measurements, 105 (79.5%) exhibited IDH1 wild-type tumors. Of the 132 patients with assessed MGMT methylation, 94 (71.2%) had MGMT methylated tumors. TERT promoter methylation was detected in 112 out of 132 cases (84.8%), while no methylation was observed in 20 cases (15.2%). Analyses using multivariable models revealed that age at histological grade ( P < 0.0001), adjuvant radiotherapy ( P < 0.014), IDH1 status ( P < 0.026), and TERT promoter status ( P < 0.030) were independently associated with OS. Conclusion The findings of this study demonstrate that patients with higher tumor histological grades who had received adjuvant radiotherapy, exhibited IDH1 mutations, or presented with TERT promoter mutations, experienced improved OS. The median survival time was 20 months, with 15.6% and 46.9% of patients surviving at 12 and 24 months, respectively. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Ethics and Research Committee of Tehran University of Medical Science, Neurosurgical Department of Sina Hospital (IR.TUMS.SINAHOSPITAL.REC.1399.111) approved this study. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The authors confirm that the data supporting the findings of this study are available within the article.