Molecular marker testing and reporting completeness for adult-type diffuse gliomas in the United States.

IF 2.4 Q2 CLINICAL NEUROLOGY

Neuro-oncology practice Pub Date : 2022-10-07 eCollection Date: 2023-02-01 DOI:10.1093/nop/npac079

Corey Neff, Gino Cioffi, Kristin Waite, Carol Kruchko, Jill S Barnholtz-Sloan, Quinn T Ostrom, J Bryan Iorgulescu

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引用次数: 1

Abstract

Background: A newly developed brain molecular marker (BMM) data item was implemented by US cancer registries for individuals diagnosed with brain tumors in 2018-including IDH and 1p/19q-co-deletion statuses for adult-type diffuse gliomas. We thus investigated the testing/reporting completeness of BMM in the United States.

Methods: Cases of histopathologically confirmed glioblastoma, astrocytoma, and oligodendroglioma diagnosed in 2018 were identified in the National Cancer Database. Adjusted odds ratios (OR_adj) and 95% confidence intervals (CI) of BMM testing/reporting were evaluated for association with the selected patient, treatment, and facility-level characteristics using multivariable logistic regression. As a secondary analysis, predictors of MGMT promoter methylation testing/reporting among IDH-wildtype glioblastoma individuals were assessed. Key limitations of the BMM data item were that it did not include any details regarding testing technique or assay type and could not distinguish between a lack of testing and a lack of cancer registry reporting of testing results.

Results: Among 8306 histopathologically diagnosed adult-type diffuse gliomas nationally, overall BMM testing/reporting completeness was 81.1%. Compared to biopsy-only cases, odds of testing/reporting increased for subtotal (OR_adj= 1.38 [95% CI: 1.20-1.59], P < .001) and gross total resection (OR_adj=1.50 [95% CI: 1.31-1.72], P < .001). Furthermore, the odds were lowest at community centers (hospitals (67.3%; OR_adj=0.35 [95% CI: 0.26-0.46], P < .001) and highest at academic/NCI-designated comprehensive cancer centers (85.4%; referent). By geographical location, BMM testing/reporting completeness ranged from a high of 86.8% at New England (referent) to a low of 76.0 % in the West South Central region (OR_adj=0.57 [95% CI: 0.42-0.78]; P < .001). Extent of resection, Commission-on-Cancer facility type, and facility location were additionally significant predictors of MGMT testing/reporting among IDH-wildtype glioblastoma cases.

Conclusions: Initial BMM testing/reporting completeness for individuals with adult-type diffuse gliomas in the United States was promising, although patterns varied by hospital attributes and extent of resection.

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美国成人型弥漫性胶质瘤的分子标记检测和报告完整性。

背景：2018年，美国癌症注册中心为诊断为脑肿瘤的个体实施了一项新开发的脑分子标记物（BMM）数据项，包括成人型弥漫性胶质瘤的IDH和1p/19q-co-缺失状态。因此，我们调查了BMM在美国的测试/报告完整性。方法：在国家癌症数据库中确定2018年诊断的组织病理学确诊的胶质母细胞瘤、星形细胞瘤和少突胶质瘤病例。使用多变量逻辑回归评估BMM测试/报告的调整后比值比（ORadj）和95%置信区间（CI）与所选患者、治疗和设施水平特征的相关性。作为二级分析，评估了IDH野生型胶质母细胞瘤个体中MGMT启动子甲基化检测/报告的预测因素。BMM数据项的主要局限性在于，它不包括关于检测技术或检测类型的任何细节，并且无法区分缺乏检测和缺乏癌症登记处检测结果报告。结果：在全国8306例经组织病理学诊断的成人型弥漫性胶质瘤中，BMM检测/报告的总体完整性为81.1%。与仅活检的病例相比，大部切除（ORadj=1.38[95%CI:1.20-1.59]，P<.001）和全切除（ORdj=1.50[95%CI+1.31-1.72]，P<0.001）的检测/报告几率增加。此外，社区中心的发病率最低（67.3%；ORadj=0.35[95%CI:0.26-0.46]，P<.001），学术/NIC指定的癌症综合中心发病率最高（85.4%；参考文献）。根据地理位置，BMM检测/报告的完整性从新英格兰（参考）的86.8%的高到中南部地区的76.0%的低（ORadj=0.57[95%CI:0.42-0.78]；P<.001）。在IDH野生型胶质母细胞瘤病例中，切除范围、委员会-癌症设施类型和设施位置是MGMT检测/报告额外的重要预测因素。结论：在美国，成人型弥漫性胶质瘤患者的初步BMM测试/报告完整性是有希望的，尽管模式因医院属性和切除程度而异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuro-oncology practice CLINICAL NEUROLOGY-

CiteScore

5.30

自引率

11.10%

发文量

期刊介绍： Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving