P12.59.B CONDITIONAL SURVIVAL ANALYSIS IN IDH-MUTANT HIGH-GRADE GLIOMAS: AN USEFUL TOOL IN CLINICAL PRACTICE

Abstract BACKGROUND The median overall survival of patients with an IDH-mutant high-grade gliomas (IDHm HGGs), including grade 3 oligodendroglioma (O3), grade 3 and 4 astrocytoma (A3, A4), is well known. While this clinical information is useful at time of diagnosis, it fails to account for the evolving prognosis of patients who surpass initial survival expectations. The aim of our study is to estimate the conditional survival of patients enrolled in the POLA cohort. MATERIAL AND METHODS POLA cohort is a French national cohort dedicated to diagnosis, management and research about IDHm HGGs. The objective was to assess life expectancy at specific time points during follow-up for patients who remained alive five years after the initial diagnosis of O3, A3 or A4. We performed a conditional survival analysis to estimate the probability of being alive five additional years given survival at specific timepoints. We also performed a landmark survival analysis to estimate the overall survival in patients free from progression at five years. RESULTS A total of 869 patients were included: 479 O3, 179 A3 and 211 A4. The mOS was 14.9 (95% confidence interval 12.7-NA), 11.3 (9.1-NA) and 5.8 (4.2-7.9) years, respectively. The estimated probability of being alive for an additional 5 years given survival at 1, 5, and 10 years was 83% (79-86%), 79% (74-84%), and 68% (41-84%) for O3; 77% (70-83%), 72% (62-81%), and NA for A3; and 54% (47-61%), 72% (61-80%), and NA for A4. After excluding patients with less than 5 years of follow-up, we identified 388 patients (235 O3, 85 A3, 68 A4) who were progression-free 5 years after diagnosis. From the 5-year landmark, their estimated survival probability for an additional 1, 5, and 10 years was 98.3% (96.6-100%), 87.5% (82.9-92.4%), and 74.1% (64.6-85.0%) for O3; 100% (100-100%), 87.5% (79.4-96.5%), and NA for A3; 96.8% (92.9-100%), 81.4% (71.3-92.9%), and NA for A4. CONCLUSIONS Conditional survival — defined as the probability of surviving a specified number of additional years given survival to a focus point — provides a useful and hopeful prognostic indicator in IDHm HGGs long-term survivors. These data should be taken into consideration to improve clinical decision-making and patient counseling.

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Journal
Neuro-Oncology
Published
2025-10-01
DOI
https://doi.org/10.1093/neuonc/noaf193.438
Primary Topic
Glioma Diagnosis and Treatment
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article
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article

P12.59.B CONDITIONAL SURVIVAL ANALYSIS IN IDH-MUTANT HIGH-GRADE GLIOMAS: AN USEFUL TOOL IN CLINICAL PRACTICE

Dominique Figarella‐Branger, C. Ramírez, Mathilde Ducloie, Veronique Bourg et al.
Neuro-Oncology
Glioma Diagnosis and Treatment
article

P12.59.B CONDITIONAL SURVIVAL ANALYSIS IN IDH-MUTANT HIGH-GRADE GLIOMAS: AN USEFUL TOOL IN CLINICAL PRACTICE

Dominique Figarella‐Branger, C. Ramírez, Mathilde Ducloie, Veronique Bourg, Caroline Dehais, Damien Ricard, Carole Gourmelon, Stefania Cuzzubbo, Luc Bauchet, Charlotte Bronnimann, Philippe Meneï, Luc Taillandier, Clotilde Verlut, Élodie Vauléon, Alice Laurenge, Romain Appay, Thierry Faillot, Mohamed Khettab, Franck Bielle, Elizabeth Cohen‐Jonathan Moyal, Romuald Seizeur, Lisa Belin, François Ghiringhelli, Apolline Djelad, Élise Deluche, François Ducray, Émeline Tabouret, Mehdi Touat, Claude Gaultier, Olivier Chinot, Alain Carpentier, Philippe Colin, Alberto Pïcca, F. Dhermain, Ahmed Idbaïh, Olivier Langlois, Nadia Younan
article en

Abstract

Abstract BACKGROUND The median overall survival of patients with an IDH-mutant high-grade gliomas (IDHm HGGs), including grade 3 oligodendroglioma (O3), grade 3 and 4 astrocytoma (A3, A4), is well known. While this clinical information is useful at time of diagnosis, it fails to account for the evolving prognosis of patients who surpass initial survival expectations. The aim of our study is to estimate the conditional survival of patients enrolled in the POLA cohort. MATERIAL AND METHODS POLA cohort is a French national cohort dedicated to diagnosis, management and research about IDHm HGGs. The objective was to assess life expectancy at specific time points during follow-up for patients who remained alive five years after the initial diagnosis of O3, A3 or A4. We performed a conditional survival analysis to estimate the probability of being alive five additional years given survival at specific timepoints. We also performed a landmark survival analysis to estimate the overall survival in patients free from progression at five years. RESULTS A total of 869 patients were included: 479 O3, 179 A3 and 211 A4. The mOS was 14.9 (95% confidence interval 12.7-NA), 11.3 (9.1-NA) and 5.8 (4.2-7.9) years, respectively. The estimated probability of being alive for an additional 5 years given survival at 1, 5, and 10 years was 83% (79-86%), 79% (74-84%), and 68% (41-84%) for O3; 77% (70-83%), 72% (62-81%), and NA for A3; and 54% (47-61%), 72% (61-80%), and NA for A4. After excluding patients with less than 5 years of follow-up, we identified 388 patients (235 O3, 85 A3, 68 A4) who were progression-free 5 years after diagnosis. From the 5-year landmark, their estimated survival probability for an additional 1, 5, and 10 years was 98.3% (96.6-100%), 87.5% (82.9-92.4%), and 74.1% (64.6-85.0%) for O3; 100% (100-100%), 87.5% (79.4-96.5%), and NA for A3; 96.8% (92.9-100%), 81.4% (71.3-92.9%), and NA for A4. CONCLUSIONS Conditional survival — defined as the probability of surviving a specified number of additional years given survival to a focus point — provides a useful and hopeful prognostic indicator in IDHm HGGs long-term survivors. These data should be taken into consideration to improve clinical decision-making and patient counseling.

Neuro-OncologyVol. 27(Supplement_3)
Allen Institute for Brain Science (US), Lyon College (US), Université de Lille (FR), University of Reunion Island (RE), Hôpital Beaujon (FR), Institut Gustave Roussy (FR), Centre Hospitalier Universitaire de Bordeaux (FR), Centre Hospitalier Universitaire de Nice (FR), Sorbonne Université (FR), Centre Hospitalier Universitaire de La Réunion (RE), Centre Hospitalier Universitaire de Besançon (FR), L’Institut du Cancer Courlancy Reims (FR), Hopitaux Civils de Colmar (FR), Centre Hospitalier Universitaire de Montpellier (FR), Centre Georges François Leclerc (FR), Institut universitaire du cancer de Toulouse Oncopole (FR), Centre Hospitalier Régional et Universitaire de Nancy (FR), Centre Eugène Marquis (FR), Centre Hospitalier Universitaire d'Angers (FR), Centre Hospitalier Universitaire de Caen Normandie (FR), Centre Hospitalier Universitaire de Limoges (FR), Pitié-Salpêtrière Hospital (FR), Centre d'Investigation Clinique de Nantes (FR), Centre Hospitalier Régional Universitaire de Brest (FR), Peuplements végétaux et bioagresseurs en milieu tropical (RE), Hôpital d'instruction des Armées Percy (FR), Hôpital Saint-Louis (FR), Services déconcentrés d'appui à la recherche Occitanie-Montpellier (FR), Institut du Cerveau (FR), Centre Hospitalier Universitaire de Rouen (FR), Hôpital Foch (FR), Centre Hospitalier Universitaire de Saint-Étienne (FR), Hôpital de la Timone (FR), Université d'Angers (FR), Université de Rouen Normandie (FR), Nantes Université (FR), Université de Caen Normandie (FR)
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Glioma Diagnosis and Treatment
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